急性脑梗死患者血清C反应蛋白、脂联素、细胞因子和T细胞亚群与患者医院感染的相关性

Correlation between serum C-reactive protein, adiponectin, cytokines and T cell subsets in patients with acute cerebral infarction and nosocomial infection

目的探讨急性脑梗死患者血清C反应蛋白、脂联素、细胞因子和T细胞亚群与患者医院感染的相关性。方法选择2016年3月至2018年3月本院收治的急性脑梗死患者147例为研究对象,根据是否发生医院感染将其分为感染组和非感染组。分析医院感染的发生情况和感染组患者病原菌分布特点,比较两组患者C反应蛋白、脂联素、细胞因子和T细胞亚群水平差异。结果 147例急性脑梗死患者中35例发生医院感染,感染率为23.81%,其中以呼吸道感染为主,占51.43%。35例感染患者共分离病原菌46株,包括革兰氏阴性菌28株、革兰氏阳性菌16株、真菌2株。感染组患者血清C反应蛋白、肿瘤坏死因子-α、白介素-6、白介素-8和CD8+水平均显著高于未感染组,脂联素、CD4+和CD4+/CD8+水平均显著低于未感染组,差异均有统计学意义(均P <0.05)。结论急性脑梗死患者医院感染率较高,发生医院感染者C反应蛋白水平显著升高而脂联素水平显著下降,且存在细胞炎性反应和免疫功能异常,值得临床研究。

Objective To explore the correlation between serum C reactive protein, adiponectin, cytokines and T cell subsets in patients with acute cerebral infarction and nosocomial infection. Method 147 patients with acute cerebral infarction admitted to our hospital from March 2016 to March 2018 were selected as research objects. They were divided into infected group and non-infected group based on whether they had nosocomial infections, the incidence of nosocomial infection and the distribution characteristics of pathogens in infected group were analyzed, and the levels of C-reactive protein, adiponectin, cytokines and T-cell subsets in the two groups were compared. Result Among 147 patients with acute cerebral infarction, 35 patients had nosocomial infection, and the infection rate was 23.81%. 46 strains of pathogenic bacteria were isolated from the 35 infected patients, including 28 strains of Gram-negative bacteria, 16 strains of Gram-positive bacteria and 2 strains of fungi. The levels of serum C-reactive protein, tumor necrosis factor -α, interleukin-6, interleukin-8 and CD8^+ in infected group were higher than those in non-infected group, and the levels of adiponectin, CD4^+ and CD4^+/CD8^+ were lower than those in non-infected group (all P < 0.05). Conclusion The nosocomial infection rate of patients with acute cerebral infarction is relatively high. The level of C-reactive protein in patients with nosocomial infection is significantly increased and the level of adiponectin is decreased, and there are cellular inflammatory reactions and immune dysfunction, which is worthy of clinical research.