首页|血液透析导管相关性血流感染的危险因素及TGF-β1/Smads信号通路的表达

血液透析导管相关性血流感染的危险因素及TGF-β1/Smads信号通路的表达

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目的 探讨血液透析导管相关性血流感染(CRBSI)的危险因素及转化生长因子-β1(TGF-β1)/Smads信号通路的表达。方法 回顾性选取2020年1月-2023年1月成都市第五人民医院72例血液透析并发CRBSI患者为CRBSI组，另选取72例同期血液透析未并发CRBSI患者为对照组。分析血液透析患者CRBSI的危险因素。比较两组患者血清TGF-β1、Smad2、Smad3水平，分析三者单独及联合检测对血液透析患者CRBSI的诊断价值。结果 多因素分析结果显示，静脉导管置管部位为股静脉、糖尿病、导管留置时间久、透析时间≥3年、白蛋白水平＜30 g/L是血液透析患者CRBSI的危险因素(P＜0。05)。与对照组相比，CRBSI组血清TGF-β1、Smad2、Smad3水平升高(P＜0。05)。TGF-β1、Smad2、Smad3联合检测对血液透析患者CRBSI的诊断曲线下面积(AUC)值高于单独检测的AUC值(P＜0。05)，且联合检测的敏感度为86。11％，特异度为83。33％。结论 血液透析患者CRBSI后TGF-β1/Smads通路相关因子水平上调，TGF-β1、Smad2、Smad3联合检测对血液透析患者CRBSI具有较高的诊断价值，其危险因素包括静脉导管置管部位为股静脉、糖尿病、导管留置时间久、透析时间≥3年、白蛋白水平＜30 g/L。
Risk factors for catheter-related bloodstream infection and expressions of TGF-β1/Smads signaling pathways in hemodialysis patients
OBJECTIVE To explore the risk factors for catheter-related bloodstream infection(CRBSI)and expres-sions of transforming growth factor-β1(TGF-β1)/Smads signaling pathways in the hemodialysis patients.METHODS From Jan 2020 to Jan 2023,totally 72 patients who underwent hemodialysis in Chengdu Fifth People's Hospital and were complicated with CRBSI were assigned as the CRBSI group,meanwhile,72 patients who un-derwent hemodialysis and were not complicated with CRBSI were set as the control group.The risk factors for the CRBSI in the hemodialysis patients were analyzed.The levels of serum TGF-β1,Smad2 and Smad3 were compared between the two groups of patients,and the values of the single and joint detection of the three indexes in diagno-sis of CRBSI were analyzed.RESULTS The result of multivariate analysis showed that femoral venous catheteriza-tion,diabetes mellitus,no less than 3 years of dialysis and albumin level less than 30 g/L were the risk factors for the CRBSI in the hemodialysis patients(P＜0.05).The levels of serum TGF-β1,Smad2 and Smad3 of the CRBSI group were higher than those of the control group(P＜0.05).The area under curve(AUC)value of the joint de-tection of TGF-β1,Smad2 and Smad3 was greater than that of the single detection(P＜0.05);the sensitivity of the joint detection was 86.11％,with the specificity 83.33％.CONCLUSION The hemodialysis patients complicat-ed with CRBSI show upregulated levels of TGF-β1/Smads pathways.The joint detection of TGF-β1,Smad2 and Smad3 has high value in diagnosis of CRBSI.The risk factors for the CRBSI include the femoral venous catheter-ization,diabetes mellitus,long time of catheter indwelling,no less than 3 years of dialysis and albumin level less than 30 g/L.

HemodialysisCatheter-associated bloodstream infectionsRisk factorTransforming growth factor-β1/Smads signaling pathwayReceiver operating characteristic curve

刘娟、李昌艳、顾芳、唐明敏、杨雨雯

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成都市第五人民医院肾内科,四川成都 610000

血液透析 导管相关性血流感染 危险因素 转化生长因子-β1/Smads信号通路 受试者工作特征曲线

四川省科研基金资助项目

2021LK0320530

2024

10.11816/cn.ni.2024-231193

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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