首页|重症肺炎多重耐药菌感染危险因素及NLRP3/IL-1β的预测价值

重症肺炎多重耐药菌感染危险因素及NLRP3/IL-1β的预测价值

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目的 探究重症肺炎多重耐药菌(MRB)感染危险因素及NLRP3/IL-1β的预测价值。方法 选取2020年4月-2023年3月华中科技大学协和东西湖医院收治的183例重症肺炎患者为研究对象，根据MRB感染情况分为MRB感染组55例和非MRB感染组128例。比较两组临床资料，采用Logistic分析法分析危险因素;酶联免疫吸附试验检测血清NLRP3、IL-1β水平;受试者工作特征(ROC)曲线分析NLRP3、IL-1β单独及联合检测对重症肺炎患者MRB感染诊断价值。结果 重症肺炎患者MRB感染率为30。05％;危险因素包括慢性阻塞性肺疾病、有机械通气、侵入性操作时间长、感染后联合应用抗菌药物(P＜0。05);MRB感染组血清NLRP3、IL-1β水平较非MRB感染组高(P＜0。05);NLRP3、IL-1β单独及联合检测重症肺炎患者MRB感染曲线下面积(AUC)分别为0。738、0。808、0。856。联合检测的AUC高于各项单独检测(P＜0。05)，敏感度和特异度为83。60％、69。50％。结论 重症肺炎患者MRB感染发生率高，且激活了 NLRP3/IL-1β通路，联合检测NLRP3、IL-1β有助于诊断重症肺炎患者MRB感染，重症肺炎患者MRB感染与慢性阻塞性肺疾病、机械通气、侵入性操作时间、感染后联合应用抗菌药物相关。
Risk factors for multidrug-resistant organisms infections in patients with severe pneumonia and predictive value of NLRP3/IL-1β
OBJECTIVE To explore the risk factors for multidrug-resistant bacteria(MRB)infections and analyze the predictive value of NLRP3/1L-1β.METHODS A total of 183 patients with severe pneumonia who were treated in Xiehe Dongxihu Hospital of Huazhong University of Science and Technology from Apr 2020 to Mar 2023 were recruited as the research subjects and were divided into the MRB infection group with 55 cases and the non-MRB infection group with 128 cases according to the status of MRB infection.The clinical data were compared between the two groups,logistic regression analysis was performed for the risk factors,the levels of serum NLRP3 and IL-1β were detected by enzyme-linked immunosorbent assay.The values of NLRP3,IL-1β and the joint detection of the two indexes in diagnosis of MRB infection of the severe pneumonia patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The incidence of MRB infection was 30.05％among the patients with severe pneumonia.The risk factors included chronic obstructive pulmonary disease(COPD),mechanical ven-tilation,long time period of invasive operation and combined use of antibiotics after infection(P＜0.05).The lev-els of serum NLRP3 and IL-1β of the MRB infection group were higher than those of the non-MRB infection group(P＜0.05).The areas under curves(AUCs)of NLRP3,IL-1β and the join detection were respectively 0.738,0.808 and 0.856 in diagnosis of MRB infection of the severe pneumonia patients;the AUC of the joint detection was greater than that of the single detection(P＜0.05),the sensitivity was 83.60％,with the specificity 69.50％.CONCLUSION The incidence of MRB infection is high among the severe pneumonia patients,which activate the NLRP3/IL-1β pathway.The joint detection of NLRP3 and IL-1β may facilitate the diagnosis of MRB infection in the severe pneumonia patients.The MRB infection of the severe pneumonia patients is associated with chronic obstructive pulmonary disease,mechanical ventilation,time of invasive operation and combined use of antibiotics after infection.

Severe pneumoniaMultidrug-resistant bacteria infectionRisk factorNOD-like receptor heat protein domain associated protein 3Interleukin-1βDiagnostic valueReceiver operating characteristic curve

闫红霞、马磊、颜彦、徐佳、刘铮

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华中科技大学协和东西湖医院(武汉市东西湖区人民医院)综合医疗科,湖北武汉 430040

华中科技大学同济医学院附属同济医院泌尿外科,湖北武汉 430040

华中科技大学协和东西湖医院(武汉市东西湖区人民医院)肿瘤科,湖北武汉 430040

重症肺炎 多重耐药菌感染 危险因素 NOD样受体热蛋白结构域相关蛋白3 白细胞介素-1β 诊断价值 受试者工作特征曲线

湖北省卫生健康委基金武汉市医学基金

WJ2019Q024WX19C32

2024

10.11816/cn.ni.2024-231086

中华医院感染学杂志
中华预防医学会 中国人民解放军总医院

中华医院感染学杂志

CSTPCD北大核心
影响因子：1.885
ISSN：1005-4529
年,卷(期)：2024.34(6)
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