The correlation of peripheral blood STING and KLF4 with intestinal microbiota in patients with severe pneumonia and its predictive value for prognosis
Objective To explore the expression levels of interferon gene stimulating factor(STING)and Krüppel like factor 4(KLF4)in peripheral blood of patients with severe pneumonia,their correlation with gut microbiota,and their pre-dictive value for prognosis.Method A total of 110 patients with severe pneumonia admitted to our hospital from Septem-ber 2021 to September 2023 were selected as the observation group,and 105 healthy individuals who underwent physical examination during the same period were selected as the control group.On the day of admission,peripheral blood from two groups of subjects was collected,and real-time fluorescence quantitative PCR was used to detect the levels of STING and KLF4 in peripheral blood.Fecal samples of the subjects were collected,and Bifidobacterium,Lactobacillus,Escherichia coli and Enterococcus were cultured,identified,and counted.The levels of peripheral blood STING and KLF4,as well as the gut microbiota were compared between the two groups of subjects,and Pearson correlation analysis was performed to analyze the correlation of peripheral blood STING and KLF4 with the gut microbiota of severe pneumonia patients.Ac-cording to the prognosis within 28 days after treatment,the patients were divided into good prognosis group(76 survivors)and bad prognosis group(34 deaths).The clinical indicators were compared between the two groups,and the risk factors affecting prognosis of severe pneumonia were analyzed using multivariate Logistic regression method.The predictive value of peripheral blood STING and KLF4 on the prognosis of severe pneumonia was analyzed using the receiver operating characteristic curve(ROC).Results Compared with the control group,the levels of STING and KLF4 in peripheral blood,as well as the counts of Lactobacillus and Bifidobacteria in the observation group significantly reduced,while the counts of Enterococcus and Escherichia coli significantly increased(t=36.647,10.357,6.817,13.649,2.796,17.167;all P＜0.05).Pearson correlation analysis showed that the levels of STING and KLF4 in peripheral blood were positively cor-related with the counts of Bifidobacteria and Lactobacillus,while negatively correlated with those of Escherichia coli and Enterococcus(STING:r=0.293,0.231,-0.308,-0.287;KLF4:r=0.194,0.217,-0.279,-0.198;all P＜0.05).Multivariate Logistic regression analysis showed that peripheral blood levels of STING and KLF4,as well as Bifidobacteria and Es-cherichia coli,were factors affecting the prognosis of severe pneumonia(all P＜0.05).The ROC curve analysis results showed that the AUCs of peripheral blood STING and KLF4 predicting the prognosis of severe pneumonia were 0.746 and 0.730,respectively.Conclusion The levels of peripheral blood STING and KLF4 decrease in patients with severe pneu-monia,both are closely related to the imbalance of gut microbiota and poor prognosis,and can help to predict poor pro-gnosis in patients.
Severe pneumoniaInterferon gene stimulating factorKrüppel like factor 4Intestinal microbiotaPrognosis
万方数据
维普
