高迁移率族蛋白B1与呼吸衰竭伴肺部感染患者感染程度的关系及预后预测价值

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摘要目的探讨高迁移率族蛋白B1(HMGB1)与呼吸衰竭(RF)伴肺部感染(PI)患者感染程度的关系及预后预测价值。方法选取2020-03至2023-03联勤保障部队第983医院收治的RF伴肺部感染患者142例,采用临床肺部感染评分(CPIS)评估患者感染程度,分为轻度感染组(n=79)及重度感染组(n=63),检测患者HMGB1水平,采用Pearson相关系数分析RF伴肺部感染患者HMGB1与感染程度的关系。根据患者生存情况分为预后不良组及预后良好组,分析不同预后患者HMGB1水平,采用多因素logistic回归模型分析影响RF伴肺部感染患者预后的因素,并采用受试者工作特征(ROC)曲线分析HMGB1对RF伴肺部感染患者预后不良的预测价值。结果 142例中63例重度感染,79例为轻度感染,重度感染率44.37%。重度感染组HMGB1水平及CPIS评分均高于轻度感染组(P<0.05);Pearson分析结果显示,HMGB1与CPIS评分呈正相关(r=0.586,P<0.05);预后不良组患者机械通气时间、住院时间、FBG水平高于预后良好组(P<0.05);Logistic回归分析结果显示:机械通气时间长、FBG、HbAlc高水平是RF伴肺部感染患者预后不良的危险因素(P<0.05,OR>1);ROC分析结果显示:HMGB1预测RF伴肺部感染患者预后不良的灵敏度为90.38%,特异度为81.11%,曲线下面积(AUC)值(95%CI)为0.804(0.729~0.866)。结论 RF伴肺部感染患者HMGB1与感染程度密切相关,HMGB1高水平是影响RF伴肺部感染患者预后不良的危险因素,预测RF伴肺部感染预后不良价值良好。

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	张霞
	马红微
	李礼
	邱景伟

关键词 ：呼吸衰竭, 肺部感染, 感染程度, 预测

Abstract：Objective To investigate the relationship between high mobility group protein B1 (HMGB1) and the degree of infection in patients with respiratory failure (RF) and pulmonary infection (PI) and its prognostic value. Methods A total of 142 patients with RF with PI admitted to the 983rd Hospital of PLA Joint Logistics Support Force from March 2020 to March 2023 were selected. Clinical pulmonary infection score (CPIS) was used to evaluate the infection degree of the patients. The patients were divided into mild infection group (n=79) and severe infection group (n=63), and HMGB1 levels were detected. Pearson correlation coefficient was used to analyze the relationship between HMGB1 and infection degree in RF patients with lung infection. Patients were divided into poor prognosis group and good prognosis group according to their survival condition, and HMGB1 levels of the patients with different prognosis were analyzed. Clinical data of the patients were collected, and multivariate logistic regression model was used to analyze the factors affecting the prognosis of RF patients with PI. The predictive value of HMGB1 in RF patients with PI was analyzed by receiver operating characteristic (ROC) curve. Results Among the 142 patients, 63 cases were severely infected, 79 cases were mildly infected, and the severe infection rate was 44.37%. HMGB1 level and CPIS score in severe infection group were higher than those in mild infection group (P<0.05). The results of Pearson analysis showed that HMGB1 was positively correlated with CPIS score (r=0.586, P<0.05). The mechanical ventilation time, hospital stay and FBG levels in the poor prognosis group were higher than those in the good prognosis group (P<0.05). Logistic regression analysis showed that long mechanical ventilation time and high levels of FBG and HbAlc were risk factors for poor prognosis in RF patients with PI (P<0.05, OR>1). ROC analysis results showed that the sensitivity and specificity of HMGB1 in predicting poor prognosis of RF patients with pulmonary infection were 90.38% and 81.11% respectively, and the area under the curve (AUC) value (95%CI) was 0.804 (0.729-0.866). Conclusions HMGB1 is closely related to the degree of infection in RF patients with lung infection. The high level of HMGB1 is a risk factor for the poor prognosis of RF patients with lung infection, and it is of good value in predicting the poor prognosis of RF patients with lung infection.

Key words： respiratory failure lung infection degree of infection forecast

收稿日期: 2024-02-08

ZTFLH:

R563.8

通讯作者: 邱景伟,E-mail:cod2132@163.com

作者简介: 张霞,硕士,主治医师。

引用本文:

张霞, 马红微, 李礼, 邱景伟. 高迁移率族蛋白B1与呼吸衰竭伴肺部感染患者感染程度的关系及预后预测价值[J]. 武警医学, 2024, 35(8): 676-680. ZHANG Xia, MA Hongwei, LI Li, QIU Jingwei. Relationship between high mobility group protein B1 and infection degree in patients with respiratory failure and pulmonary infection and its prognostic value. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(8): 676-680.

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https://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 https://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2024/V35/I8/676

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