医院获得性铜绿假单胞菌肺炎病人CypA及其受体CD147表达与意义

EXPRESSION AND SIGNIFICANCE OF CYCLOPHILIN A AND ITS RECEPTOR CD147 IN PATIENTS WITH NOSOCOMIAL PNEUMONIA CAUSED BY PSEUDOMONAS AERUGINOSA

目的探讨亲环素A(CypA)及其受体CD147在医院获得性铜绿假单胞菌(PA)肺炎病人中的表达及意义。方法收集2021年1—12月在河南省中医院住院的罹患PA肺炎和肺炎克雷伯菌(KP)肺炎病人的临床资料。将病人分为PA组和KP组,对两组EDTA抗凝血进行血常规、降钙素原和C-反应蛋白分析,并测定两组血清和支气管肺泡灌洗液中CypA和CD147水平。结果PA组住院时长和抗菌药物使用时长显著高于KP组(t=7.332、9.919,P<0.05),而两组发病年龄和性别差异无显著性(P>0.05)。与KP组相比,PA组白细胞总数、中性粒细胞和C-反应蛋白水平显著降低(t=4.438、3.982,Z=4.010,P<0.05),而两组降钙素原水平差异无显著性(P>0.05)。与KP组相比,PA组支气管肺泡灌洗液中CypA水平显著降低(Z=2.818,P<0.05),而两组血清CypA和CD147及支气管肺泡灌洗液CD147水平差异无显著性(P>0.05)。结论PA肺炎病人支气管肺泡灌洗液中CypA相对低表达,与该菌感染慢性化存在关联,可能是其实现免疫逃逸的重要机制。

Objective To investigate the expression and significance of cyclophilin A(CypA)and its receptor CD147 in patients with nosocomial pneumonia caused by Pseudomonas aeruginosa(PA).Methods We collected the clinical data of inpatients developing PA pneumonia(PA group)or Klebsiella pneumoniae(KP)pneumonia(KP group)in Henan Province Hospital of Traditional Chinese Medicine from January 2021 to December 2021.The two groups had routine blood examination and measurements of C-reactive protein and procalcitonin levels in EDTA-anticoagulated blood and CypA and CD147 levels in serum and bronchoalveolar lavage fluid.Results The length of hospital stay and duration of antibiotic use of the PA group were significantly higher than those of the KP group(t=7.332,9.919;P<0.05).There was no significant difference in age of onset or sex(P>0.05).Compared with the KP group,the PA group showed a significantly lower total leukocyte count,a significantly lower neutrophil count,and a significantly lower C-reactive protein level(t=4.438,3.982,Z=4.010,P<0.05),with no significant difference in procalcitonin level(P>0.05).The CypA level in bronchoalveolar lavage fluid was significantly lower in the PA group than in the KP group(Z=2.818,P<0.05).There was no significant difference in serum CypA level or CD147 level in serum or bronchoalveolar lavage fluid(P>0.05).Conclusion The relatively low CypA expression in bronchoalveolar lavage fluid in patients with PA pneumonia is associated with the chronicity of PA infection,which may facilitate the immune escape of the pathogen.