Risk factors for pulmonary infection and association with mitogen-activated protein kinases signaling pathways of patients with severe craniocerebral injury
OBJECTIVE To explore the association between pulmonary infection and mitogen-activated protein kina-ses(MAPK)signaling pathways of the patients with severe craniocerebral injury and analyze the risk factors for the pulmonary infection.METHODS A total of 120 patients with severe craniocerebral injury who were treated in Tongxiang Second People's Hospital from Feb 2020 to Feb 2023 were recruited as the research subjects and were divided into the infection group with 55 cases and the non-infection group with 65 cases according to the status of pulmonary infection.Logistic analysis was performed for the risk factors for the pulmonary infection in the pa-tients with severe craniocerebral injury.The expressions of key factors of MAPK pathways were detected by real-time fluorescent quantitative polymerase chain reaction(RT-qPCR).The levels of p38,extracellular regulated protein kinases(ERK)and stress-activated protein kinase(JNK)were compared between the two groups.The values of p38,ERK,JNK and the joint detection in diagnosis of the pulmonary infection were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The incidence of pulmonary infection was 45.83％(55/120)among the patients with severe craniocerebral injury.The no less than 60 years of age,complication with diabetes mellitus,mechanical ventilation,tracheotomy and low level of serum albumin were the risk factors for the pulmonary infection in the patients with severe craniocerebral injury(P＜0.05).The levels of p38,ERK and JNK of the infection group were significantly higher than those of the non-infection group(P＜0.05).The area un-der curve(AUC)of the joint detection of p38,ERK and JNK was significantly higher than that of the single de-tection in diagnosis of the pulmonary infection in the patients with severe craniocerebral injury(P＜0.05),the sen-sitivity and specificity were high.CONCLUSION The incidence of pulmonary infection is high among the patients with severe craniocerebral injury,and the MAPK pathways are activated after the infection occurs.The joint de-tection of p38,ERK and JNK may facilitate the diagnosis of pulmonary infection.The pulmonary infection in the patients with severe craniocerebral injury is associated with the age,complication with diabetes mellitus,mechani-cal ventilation,tracheotomy and serum ALB.
Severe craniocerebral injuryPulmonary infectionRisk factorMitogen-activated protein kinaseDi-agnostic valueReceiver operating characteristic curve
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