重症监护病房患者呼吸机相关性肺炎影响因素及高迁移率族蛋白1表达对预后的影响

The effect of high mobility group box-1 protein on prognosis of ventilator associated pneumonia in patients in ICU

目的探讨重症监护病房(ICU)患者呼吸机相关性肺炎的影响因素及高迁移率族蛋白1表达对预后的影响。方法 2016年1月至2017年1月连续性收集该院收治的使用呼吸机的ICU患者143例,探讨ICU患者呼吸机相关性肺炎的危险因素;检测1、3、5、7d时高迁移率族蛋白1,分析院内病死率与不同时间点高迁移率族蛋白1的相关性。结果多因素Logistic回归分析显示机械通气时间大于或等于14d、高迁移率族蛋白1大于或等于50pg/mL是ICU患者呼吸机相关性肺炎的危险因素(P<0.05)。病死患者19例与存活患者比较,其入院第1、3、5、7天时高迁移率族蛋白1均显著升高[(66.68±18.69)vs.(53.37±17.57)pg/mL,P=0.003)]、[(82.21±15.68)vs.(50.65±15.59)pg/mL,P=0.000)]、[(86.53±22.14)vs.(53.06±14.28)pg/mL,P=0.000)]、[(86.37±25.02)vs.(51.38±14.84)pg/mL,P=0.000)],差异有统计学意义(P<0.05)。结论机械通气时间大于或等于14d、高迁移率族蛋白1大于或等于50pg/mL是ICU患者呼吸机相关性肺炎的危险因素,高迁移率族蛋白1升高可能与患者预后不良有关。

Objective To investigate the effect of high mobility group box-1 protein on prognosis of ventilator associated pneumonia in patients in ICU.Methods From January 2016 to January 2017,143 Continuous patients in ICU with ventilator respirator were collected.Multiple regression analysis was used to explore the risk factors of ventilator associated pneumonia in patients in ICU.High mobility group box-1 protein at 1,3,5 and 7 dwere detected.Moreover,the association between in-hospital mortality and high mobility group box-1 protein of different times were analyzed.Results Logistic regression analysis showed that the duration of mechanical ventilation≥14 dand High mobility group box-1 protein≥50 pg/mL were risk factors of ventilatorassociated pneumonia in patients in ICU（P〈0.05）.A total of 19 patients died during hospitalization.When compared with the survivals,patients suffered from mortality at 1,3,5 and 7 dgot elevated levels of high mobility group box-1 protein[（66.68±18.69）vs.（53.37±17.57）pg/mL,P=0.003,（82.21±15.68）vs.（50.65±15.59）pg/mL,P=0.000,（86.53±22.14）vs.（53.06±14.28）pg/mL,P=0.000]and [（86.37±25.02）vs.（51.38±14.84）pg/mL,P=0.000].Conclusion The duration of mechanical ventilation≥14 dand high mobility group box-1 protein≥50 pg/mL were risk factors of ventilator-associated pneumonia in patients in ICU,an elevated level of high mobility box-1 protein may be related to poor prognosis.