PCI术后肺部感染患者血清miR-146a、Galectin-3表达及与抗感染疗效的关系

Expression of serum miR-146a and Galectin-3 in patients with pulmonary infection after PCI and their relationship with anti-infection efficacy

目的探讨经皮冠状动脉介入治疗(Percutaneous coronary intervention,PCI)术后肺部感染患者血清miR-146a、半乳糖凝集素-3(Galectin-3)表达及与抗感染疗效的关系。方法选取本院收治的507例行PCI术患者作为研究对象,根据有无肺部感染分为感染组(n=76)和未感染组(n=431)。比较两组不同时间血清miR-146a、Galectin-3、肺部感染评分(Clinical pulmonary infection score,CPIS)、急性生理和慢性健康(APACHEⅡ)评分,分析各指标诊断价值。结果术后1、3、7 d感染组血清miR-146a、Galectin-3水平高于未感染组,差异有统计学意义(P<0.05);术后1、3、7 d感染组CPIS、APACHEⅡ评分高于未感染组(P<0.05);术后3 d血清miR-146a、Galectin-3与术后3 d CPIS评分、APACHEⅡ评分呈正相关(P<0.05);术后3 d miR-146a、Galectin-3联合诊断PCI术后肺部感染的AUC值大于任一指标单独检测(P<0.05);术后1、3、7 d有效患者血清miR-146a、Galectin-3水平低于无效患者(P<0.05)。结论 PCI术后肺部感染患者血清miR-146a、Galectin-3表达与CPIS、APACHEⅡ评分关系密切,可作为临床诊断的客观依据,且高表达患者常规抗感染治疗效果欠佳,临床需结合其表达情况早期调整治疗方案以促进病情转归。

Objective To explore the relationship between serum miR-146 a and Galectin-3 expression in patients with pulmonary infection after percutaneous coronary intervention(PCI)and their antiinfective efficacy.Methods A total of 507 patients who underwent PCI in our hospital were selected as the research subjects.They were divided into an infected group(n=76)and an uninfected group(n=431)according to the presence or absence of pulmonary infection.The serum miR-146 a,Galectin-3,clinical pulmonary infection score(CPIS),acute physiology and chronic health(APACHEⅡ)score were compared between the two groups at different times,and the diagnostic value of each index was analyzed.Results The levels of serum miR-146 a and Galectin-3 in the infected group were higher than those in the uninfected group at 1 day,3 days,and 7 days after operation,and the difference was statistically significant(P<0.05);the CPIS and APACHEⅡscores in the infected group were higher than those in the uninfected group on 1 day,3 days,and 7 days after operation(P<0.05);serum miR-146 a and Galectin-3 at 3 days postoperatively were positively correlated with CPIS score and APACHEⅡscore at 3 days postoperatively(P<0.05);at 3 days after operation,the AUC value of miR-146 a and Galectin-3 combined to diagnose pulmonary infection after PCI was greater than that of any indicator alone(P<0.05);serum miR-146 a and Galectin-3 levels of effective patients were lower than those of ineffective patients on 1 day,3 days,and 7 days after operation(P<0.05).Conclusion The expression of serum miR-146 a and Galectin-3 in patients with pulmonary infection after PCI is closely related to the CPIS and APACHEⅡscores,which can be used as an objective basis for clinical diagnosis.Moreover,the effect of conventional anti-infective therapy in patients with high expression is not good,and the clinical need to adjust the treatment plan in combination with its expression in order to promote the outcome of the disease.