血清HRG、Nampt水平与呼吸机相关性肺炎患者预后的关系及对预后的预测价值

The relationship between serum HRG,Nampt levels and prognosis of ventilator-associated pneumonia patients and their predictive value

目的探讨呼吸机相关性肺炎(VAP)患者血清富组氨酸糖蛋白(HRG)、烟酰胺磷酸核糖转移酶(Nampt)水平与预后的关系及对预后的预测价值。方法选取2019年2月至2020年1月于孝感市中心医院重症医学科住院行机械通气治疗且发生VAP的患者86例作为VAP组,选择同期行机械通气治疗但未发生VAP的患者73例作为非VAP组,选择90例健康体检者作为对照组。采用酶联免疫吸附试验检测血清HRG和Nampt水平。比较3组血清HRG、Nampt水平;采用多因素Logistic回归分析影响VAP患者预后的独立危险因素;使用受试者工作特征曲线(ROC曲线)评估血清HRG和Nampt单独及联合检测对VAP患者预后的预测价值。结果对照组血清HRG水平高于VAP组和非VAP组,血清Nampt水平低于VAP组,差异有统计学意义(P<0.05);非VAP组血清HRG水平高于VAP组,血清Nampt水平低于VAP组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄>60岁、合并糖尿病、机械通气治疗时间>72 h、未使用抗菌药物、气管切开、血清HRG水平降低、Nampt水平升高是VAP患者预后的独立危险因素(P<0.05)。ROC曲线分析结果显示,血清HRG预测VAP患者预后的曲线下面积(AUC)为0.742,血清Nampt预测VAP患者预后的AUC为0.808,血清HRG联合Nampt预测VAP患者预后的AUC为0.851。结论血清HRG水平降低、Nampt水平升高是VAP患者预后的独立危险因素,且二者联合检测对VAP患者的预后有较高的预测价值,可以用来辅助评估VAP患者的预后情况。

Objective To investigate the relationship between serum histidine-rich glycoprotein(HRG)and nicotinamide phosphoribosyltransferase(Nampt)and prognosis of ventilator-associated pneumonia(VAP)patients and their predictive value.Methods A total of 86 patients with VAP who received mechanical ventilation treatment in the Department of Critical Care Medicine of Xiaogan Central Hospital from February 2019 to January 2020 were selected as the VAP group,and 73 patients who received mechanical ventilation treatment at the same time but did not develop VAP were selected as the non-VAP group,and 90 healthy patients underwent physical examination were selected as the control group.Enzyme-linked immunosorbent assay was used to detect serum HRG and Nampt levels.Compared the serum HRG and Nampt levels among the 3 groups.Used multivariate Logistic regression to analyze the independent risk factors affect the prognosis of VAP patients.The receiver operating characteristic curve(ROC curve)was used to evaluate the predictive value of serum HRG and Nampt alone and in combination on the prognosis of VAP.Results The serum HRG level in the control group was higher than that in the VAP group and the non-VAP group,and the serum Nampt level was lower than that in the VAP group,the difference was statistically significant(P<0.05).The serum HRG level in the non-VAP group was higher than that in the VAP group,and the serum Nampt level was lower than that in the VAP group,the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that age>60 years,diabetes,mechanical ventilation treatment time>72 h,no use of antibiotics,tracheotomy,decreased serum HRG level,elevated Nampt level were independent risk factors for the prognosis of VAP patients(P<0.05).The ROC curve analysis results showed that the area under the curve(AUC)of serum HRG in predicting the prognosis of VAP patients was 0.742,and the AUC of serum Nampt in predicting the prognosis of VAP patients was 0.808,the AUC of serum HRG combined with Nampt in predicting the prognosis of VAP patients was 0.851.Conclusion The decrease of serum HRG level and the increase of Nampt level are the risk factors for the prognosis of VAP patients,and the combined detection of the two indexes has a high predictive value for the prognosis of VAP patients,which can be used to assist in the evaluation of the prognosis of VAP patients.