Serum TLR4,TREM1 in hemorrhagic stroke patients after minimally invasive hematoma drainage and their predictive value for pulmonary infection
OBJECTIVE To explore serum Toll-like receptor 4(TLR4),triggering receptor expressed on myeloid cell 1(TREM1)in hemorrhagic stroke patients after minimally invasive hematoma drainage and their predictive value for pulmonary infection.METHODS A total of 110 hemorrhagic stroke patients who underwent minimally in-vasive hematoma drainage in Neurosurgery Department of Lin'an District First People's Hospital were selected be-tween Jan.2021 and Dec.2023,and were divided into 27 cases in the infection group and 83 cases in the non-infec-tion group according to occurrence of pulmonary infection after minimally invasive hematoma drainage.The spu-tum of patients was collected to isolate and identify pathogens.The levels of serum TLR4,myeloid differentiation factor 88(MyD88)and TREM1 within 24h after surgery were detected by enzyme-linked immunosorbent assay.The relationship among serum TLR4,TREM1 and MyD88 in patients with hemorrhagic stroke was analyzed by Pearson correlation analysis.The predictive value of serum TLR4 and TREM1 for pulmonary infection after mini-mally invasive hematoma drainage in hemorrhagic stroke patients was analyzed by receiver operating characteristic(ROC)curves.RESULTS The incidence of pulmonary infection in hemorrhagic stroke patients after minimally in-vasive hematoma drainage was 24.55％(27/110),with a total of 34 culture isolates of pathogenic bacteria,pre-dominately Klebsiella pneumoniae(29.41％)and Pseudomonas aeruginosa(17.65％).The levels of serum TLR4,TREM1 and MyD88 in the infection group were(17.32±4.28)pg/L,(352.69±83.45)ng/L and(3.78±0.42)ng/L,higher than those in the non-infection group(P＜0.05).Serum TLR4 in hemorrhagic stroke patients was positively correlated with TREM1 and MyD88(r=0.791,0.869,all P＜0.001),and TREM1 was also positively correlated with MyD88(r=0.784,P＜0.001).The area under curve(AUC)of serum TLR4 and TREM1 alone and in combination to predict the occurrence pulmonary infection after minimally invasive hematoma drainage in hemorrhagic stroke patients before surgery were 0.839,0.826,and 0.916.CONCLUSION In patients with hemorrhagic stroke after minimally invasive hematoma drainage,TLR4 and TREM1 were abnormally elevat-ed in serum of patients with pulmonary infection,and the combined detection of serum TLR4 and TREM1 before surgery had a high predictive value for pulmonary infection after minimally invasive hematoma drainage in hemor-rhagic stroke patients.
Hemorrhagic strokeMinimally invasive hematoma drainagePulmonary infectionToll-like receptor 4Triggering receptor expressed on myeloid cell 1Predictive value
万方数据
维普
