Correlation between the expression of TLR4-NF-κB signaling pathway and pulmonary infection in patients with cerebral infarction and its risk factors
OBJECTIVE To investigate the association between the expression of toll-like receptor 4(TLR4)/nucle-ar transcription factor-κB(NF-κB)signaling pathway and pulmonary infection in patients with cerebral infarction(CI)and its risk factors and countermeasures.METHODS The clinical data of 311 CI patients admitted to Sichuan People's Hospital from Apr 2020 to Mar 2023 were retrospectively analyzed,and they were divided into the infec-ted group(56 cases)and non-infected group(255 cases)according to whether the pulmonary infection oc-curred.The clinical data between the two groups were compared and the risk factors of pulmonary infection in CI patients were analyzed by Multivariate logistic analysis.The expression levels of TLR4 and NF-κB in serum were detected by Western blot and were compared between the infected and non-infected groups.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of TLR4 and NF-κB in patients with CI com-plicated with pulmonary infection.RESULTS The incidence of pulmonary infection in cerebral infarction patients was 18.01％(56/311).Multivariate logistic regression analysis showed that age ≥60 years old,smoking history,history of pulmonary disease,NIHSS score＞14 and high C-reactive protein(CRP)to albumin(ALB)ratio were all risk factors for pulmonary infection in patients with cerebral infarction(P＜0.05).The levels of TLR4 and NF-κB in the infected group were higher than those in the non-infected group(P＜0.05).The AUC values of TLR4 and NF-κB individual and combined detection in the diagnosis of cerebral infarction patients with pulmonary infec-tion were 0.783,0.726 and 0.892,respectively.The AUC of combined diagnosis was higher than that of single detection(P＜0.05),and the sensitivity and specificity were 83.90％and 78.00％.CONCLUSION The incidence of pulmonary infection is higher in patients with CI,and related to age,smoking history,pulmonary disease histo-ry,NIHSS score at admission and CRP to ALB ratio.The TLR4/NF-κB pathway could be activated after pulmo-nary infection.The combined detection of TLR4 and NF-κB is helpful for the diagnosis of pulmonary infection in patients with CI.
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