急性心肌梗死合并肺部感染病原菌分布及高敏肌钙蛋白、肌酸激酶同工酶与乳酸脱氢酶水平变化与炎性因子的关系

The distribution of pathogenic bacteria in acute myocardial infarction complicated with pulmonary infection and the relationship between the changes in the levels of high-sensitivity troponin I,creatine kinase isoenzyme,lactate dehydrogenase and the inflammatory factors

目的分析急性心肌梗死合并肺部感染病原菌分布及高敏肌钙蛋白(hsTnI),肌酸激酶同工酶(CK-MB)与乳酸脱氢酶(LDH)水平变化与炎性因子的关系。方法2017年5月至2021年3月我院收治的92例急性心肌梗死患者,根据有无肺部感染分为感染组(n=40)和未感染组(n=52)。统计感染患者病原菌分布情况,分析hsTnI、CK-MB与LDH水平变化及其与炎性因子(白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的相关性。结果40例感染患者病原菌分布中革兰阴性菌23例(57.50%)、革兰阳性菌17例(42.50%);感染组IL-2、IL-6、TNF-α、hsTnI、CK-MB与LDH水平均高于未感染组(P<0.05);hsTnI、CK-MB、LDH与炎性因子IL-2、IL-6及TNF-α均呈正相关(P<0.05)。结论临床需根据急性心肌梗死合并肺部感染患者病原菌分布情况,为患者选取对应抗菌药物提供参考依据;hsTnI、CK-MB、LDH与炎性因子存在一定的相关性,可为临床治疗以及病情判断提供参考。

Objective To analyze the distribution of pathogenic bacteria in acute myocardial infarction combined with lung infection and the relationship between the changes in the levels of high-sensitivity troponin I(hsTnI),creatine kinase isoenzyme(CK-MB)and lactate dehydrogenase(LDH)and the inflammatory factors.Methods Ninety-two patients with acute myocardial infarction treated in our hospital from May 2017 to March 2021 were divided into an infected group(n=40)and an uninfected group(n=52)according to the presence or absence of lung infection.The distribution of pathogenic bacteria in the infected patients was counted.The changes in the levels of hsTnI,CK-MB and LDH,and the relationship between the indexes and the inflammatory factors such as interleukin-2(IL-2),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were analyzed.Results Among the 40 infected patients,23(57.50%)were gram-negative bacteria,and 17(42.50%)were gram-positive bacteria.The levels of IL-2,IL-6 and TNF-α,hsTnI,CK-MB and LDH in the infected group were higher than those in the uninfected group(P<0.05).The levels of hsTnI,CK-MB,and LDH were positively correlated with the levels of inflammatory factors IL-2,IL-6 and TNF-α(P<0.05).Conclusion Clinically,it is necessary to provide reference to select corresponding antibacterial drugs according to the distribution of pathogenic bacteria in patients with acute myocardial infarction complicated by pulmonary infection.There is a certain correlation between hsTnI,CK-MB,LDH,and inflammatory factors.This can provide reference for clinical treatment and disease judgment.