首页|冠心病PCI术后肺部感染外周血L-Arg/NOS/NO信号通路表达与其对预后的诊断价值

冠心病PCI术后肺部感染外周血L-Arg/NOS/NO信号通路表达与其对预后的诊断价值

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目的 探究冠心病经皮冠状动脉介入治疗(PCI)术后肺部感染外周血L-精氨酸/一氧化氮合酶/一氧化氮(L-Arg/NOS/NO)信号通路表达与其对预后的诊断价值.方法 选取廊坊市第四人民医院2020年6月-2023年6月收治的187例冠心病PCI手术患者为研究对象,根据术后是否发生肺部感染分为感染组69例和非感染组118例,感染组患者根据30 d预后情况分为良好预后组43例和不良预后组26例.统计感染组现况及病原菌分布;比较各组血小板L-Arg转运量、NOS活性、亚硝酸盐(NO2-)水平.采用受试者工作特征(ROC)曲线分析L-Arg、NOS、NO2-对冠心病PCI术后肺部感染患者不良预后的诊断价值.结果 187例冠心病PCI手术患者术后肺部感染发生69例(36.90％),检出病原菌79株,以革兰阴性菌为主,主要为铜绿假单胞菌.感染组L-Arg、NOS、NO2-水平低于非感染组(P＜0.05),不良预后组L-Arg、NOS、NO2-水平低于良好预后组(P＜0.05).L-Arg、NOS、NO2-联合诊断冠心病PCI术后肺部感染患者不良预后曲线下面积(AUC)高于单一检测(P＜0.05).结论 冠心病PCI术后肺部感染发生率高,病原菌以革兰阴性菌为主;冠心病PCI术后肺部感染患者及其不良预后L-Arg/NOS/NO信号通路表达异常,L-Arg、NOS、NO2-联合检测可提高冠心病PCI术后肺部感染患者不良预后的诊断价值.
Expressions of L-Arg/NOS/NO signaling pathways in peripheral blood of coronary heart disease patients with pulmonary infection after PCI and values in diagnosis of prognosis
OBJECTIVE To explore the expressions of L-arginine/nitric oxide synthase/nitric oxide(L-Arg/NOS/NO)in peripheral blood of the coronary heart disease(CHD)patients with pulmonary infection after percutaneous coronary intervention(PCI)and analyze the values in diagnosis of the prognosis.METHODS A total of 187 CHD patients who underwent PCI in Langfang Fourth People's Hospital from Jun 2020 to Jun 2023 were recruited as the research subjects and were divided into the infection group with 69 cases and the non-infection group with 118 cases according to the status of postoperative pulmonary infection.The patients of the infection group were divided into the favorable prognosis group with 43 cases and the poor prognosis group with 26 cases according to the status of 30-day prognosis.The prevalence and etiological characteristics of the infection group were statistically analyzed.The platelet transshipment volume of L-Arg,activity of NOS and level of nitrite(NO2-)were compared among the groups.The values of L-Arg,NOS and NO2-in diagnosis of poor prognosis of the CHD and PCI patients with postoperative pulmonary infection were studied by receiver operating characteristic(ROC)curve.RESULTS Among the 187 CHD patients undergoing PCI,69(36.90％)had postoperative pulmonary infection.Totally 79 strains of pathogens were isolated,among which gram negative bacteria,and Pseudomonas aeruginosa was the predominant species.The levels of L-Arg,NOS and NO2-of the infection group were lower than those of the non-infection group(P＜0.05);the levels of L-Arg,NOS and NO2-of the poor prognosis group were lower than those of the favorable prognosis group(P＜0.05).The area under curve(AUC)of the joint detection of L-Arg,NOS and NO2-was higher than that of the single detection in diagnosis of the poor prognosis of the CHD and PCI patients with postoperative pulmonary infection(P＜0.05).CONCLUSION The incidence of pulmonary infection is high a-mong the CHD patients after PCI.The gram-negative bacteria are dominant among the pathogens.The CHD and PCI patients with postoperative pulmonary infection and the patients with poor prognosis show abnormal expres-sions of L-Arg/NOS/NO signaling pathways.The joint detection of L-Arg,NOS and NO2-may raise the value in diagnosis of poor prognosis of the CHD and PCI patients with postoperative pulmonary infection.

Coronary heart diseasePercutaneous coronary interventionPostoperative infectionPulmonary infec-tionPathogenL-arginine/nitric oxide synthase/nitric oxide pathwayReceiver operating characteristic curvePrognosisDiagnosis value

王鹏、韩静华、贾晶晶、边伟红、范东娜、张冬艳

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廊坊市第四人民医院心内二科,河北廊坊 065700

廊坊市第四人民医院心功能室,河北廊坊 065700

廊坊市第四人民医院内科,河北廊坊 065700

冠心病 经皮冠状动脉介入治疗 术后感染 肺部感染 病原菌 L-精氨酸/一氧化氮合酶/一氧化氮通路 受试者工作特征曲线 预后 诊断价值

河北省科研基金资助项目廊坊市科技局自筹经费基金资助项目

2022LK031142020013057

2024

10.11816/cn.ni.2024-231856

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(13)
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