Risk factors of complicated nosocomial infection and predictive value of miR-155,NLR and PTH in maintenance hemodialysis patients
OBJECTIVE To investigate the risk factors of nocomial infection and the predictive value of micro ribo-nucleic acid(miR-155),neutrophil/lymphocyte ratio(NLR)and parathyroid hormone(PTH)in maintenance he-modialysis(MHD)patients.METHODS Clinical data of 388 patients undergoing MHD in the Seventh People's Hospital of Zhengzhou from Jan 2020 to Dec 2022 were retrospectively collected in the study.They were divided into the infected group(n=53)and the non-infected group(n=335)according to whether nosocomial infection occurred in the patients.The risk factors of nosocomial infection in MHD patients were analyzed,the levels of ser-um miR-155 and venous blood NLR and PTH were compared between the two groups.The predictive value of in-dividual and combined detection of miR-155,NLR and PTH for nosocomial infection in MHD patients was ana-lyzed.RESULTS Nosocomial infection occurred in 53 of 388 patients(13.66％)undergoing MHD.Long dialysis time,anemia,hypoproteinemia,diabetes and low level of hemoglobin(Hb)were risk factors for nosocomial in-fection in MHD patients(P＜0.05).Compared with the non-infected group,the levels of serum miR-155,plasma NLR and PTH in the infected group were higher(P＜0.05).The area under the diagnostic curve(AUC)value of the combined detection of miR-155,NLR and PTH for nosocomial infection in MHD patients was higher than that of the individual detection(P＜0.05),and the sensitivity and specificity of the combined detection were 96.23％and 79.40％,respectively.CONCLUSION The incidence of nosocomial infection in MHD patients is higher,and its risk factors include long dialysis time,anemia,hypoproteinemia,diabetes,and low level of Hb.The serum level of miR-155 and plasma levels of NLR and PTH in these patients are higher,and the combined detection of the three indexes was of high diagnostic value.
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