糖尿病合并肺部感染患者纤维蛋白原与抗apoA-1IgG及NLR的研究

Fibrinogen,anti-apoA-1 IgG and NLR in diabetic patients with pulmonary infection

目的探讨糖尿病合并肺部感染患者纤维蛋白原(Fib)、载脂蛋白A1自身抗体(抗apoA-1IgG)水平及中性粒细胞淋巴细胞比率(NLR)的表达及意义。方法回顾性分析2015年2月-2018年12月于郑州大学第一附属医院进行治疗的糖尿病患者542例的临床资料,并依据肺部感染分为感染组75例和未感染组467例。统计感染组患者病原菌情况;比较两组患者Fib、抗apoA-1IgG、NLR水平、免疫功能、炎症因子及其他血液指标水平变化。结果542例糖尿病患者中,肺部感染患者为75例,感染率为13.84%;肺部感染患者共培养分离病原菌89株,其中革兰阴性菌55株占61.80%(55/89),革兰阳性菌24株占26.97%,真菌10株占11.24%。感染组患者Fib、抗apoA-1IgG、NLR分别为(6.36±1.09)g/L、(0.38±0.10)、(4.33±1.06)均高于未感染组(P<0.001)。感染组患者CD3^+、CD4^+分别为(60.12±2.41)%、(23.06±1.84)%均低于未感染组(P<0.001)。感染组患者白细胞介素-6(IL-6)、降钙素原(PCT)、C-反应蛋白(CRP)分别为(92.66±8.03)ng/L、(13.17±2.34)ng/ml、(30.66±5.24)mg/L高于未感染组(P<0.001)。感染组患者内皮素(ET)为(75.09±13.83)ng/L高于未感染组,降钙素基因相关肽(CGRP)为(30.11±15.26)ng/L低于未感染组(P<0.001)。结论糖尿病合并肺部感染能对患者Fib、抗apoA-1IgG、NLR及机体免疫功能产生不同程度的影响,且感染以革兰阴性菌为主要致病菌,而明确感染原因对临床医生指导病情意义重大。

OBJECTIVE To explore the expression and significance of fibrinogen(fib),anti-apoA-1 IgG and NLR in diabetic patients with pulmonary infection.METHODS The clinical data of 542 patients with diabetes treated in the first affiliated hospital of zhengzhou university from Feb.2015 to Dec.2018 were retrospectively analyzed.According to pulmonary infection,the patients were divided into infection group(75 cases)and uninfected group(467 cases).The etiological results of the infected patients were analyzed and Fib,anti-apoA-1 IgG,NLR levels,immune function,inflammatory factors and other blood indicators were measured and compared between the two groups.RESULTS Among 542 patients with diabetes mellitus,75 patients had pulmonary infection,the infection rate was 13.84%.89 strains of pathogenic bacteria were isolated from patients with pulmonary infection,of which 55 strains were gram-negative,accounting for 61.80%(55/89),24 strains were gram-positive,accounting for 26.97%,and 10 strains were fungi,accounting for 11.24%,respectively.Fib,anti-apoA-1 IgG and NLR levels in the infected group was(6.36±1.09)g/L,(0.38±0.10),(4.33±1.06),respectively,significantly higher than those in the uninfected group(P<0.001).The levels of CD3^+and CD4^+in the infected group was(60.12±2.41)%,(23.06±1.84)%,respectively,significantly lower than those in the uninfected group(P<0.001).The levels of interleukin-6(IL-6),procalcitonin(PCT)and C-reactive protein(CRP)in the infected group was(92.66±8.03)ng/L,(13.17±2.34)ng/mL,and(30.66±5.24)mg/L,respectively,higher than those in the uninfected group(P<0.001).ET in infected group was(75.09±13.83)ng/L,significantly higher than that in uninfected group,and CGRP was(30.11±15.26)ng/L,significantly lower than that in uninfected group(P<0.001).CONCLUSION Diabetes mellitus complicated with pulmonary infection can affect the levels of Fib,anti-apoA-1 IgG,NLR and immune function of patients in varying degrees.Gram-negative bacilli are the main pathogens of diabetes mellitus infection.It is of great significance for clinicians to understand the cause of infection.