冠心病合并肺部感染患者中性粒细胞CD64及Toll样受体的表达及临床意义

Expression and clinical significance of neutrophil CD64 and Toll-like receptor in patients with coronary heart disease complicated with pulmonary infection

目的探讨冠心病合并肺部感染患者中性粒细胞CD64、Toll样受体(TLR)的表达水平及临床意义。方法将2019年7月至2022年7月该院收治的冠心病患者86例纳入研究,依据是否合并肺部感染分为感染组(35例)与非感染组(51例)。另外,选取进行体检的健康志愿者50例作为对照组,比较3组中性粒细胞CD64指数、TLR2、TLR4水平的差异,分析CD64指数与TLR2、TLR4的相关性,绘制受试者工作特征(ROC)曲线分析CD64指数、TLR2、TLR4诊断冠心病合并肺部感染的效能。结果3组CD64指数、TLR2、TLR4水平比较差异有统计学意义(P<0.05);感染组上述各指标均高于非感染组与对照组(P<0.05);非感染组上述各指标均高于对照组(P<0.05)。Pearson相关分析显示,TLR2、TLR4均与中性粒细胞CD64指数呈正相关(P<0.05)。ROC曲线显示,CD64指数与TLR2、TLR4用于冠心病合并肺部感染诊断的曲线下面积(AUC)分别为0.922、0.929、0.662,CD64指数、TLR2有较高诊断效能,当取最佳界值时,CD64指数和TLR2的灵敏度、特异度分别为0.943、0.804和0.914、0.902。结论中性粒细胞CD64、TLR2、TLR4表达在冠心病患者发生肺部感染时明显增加,CD64指数与TLR2在冠心病合并肺部感染中有较高诊断效能。

Objective To investigate the expression levels and clinical significance of neutrophil CD64 and Toll-like receptor(TLR)in patients with coronary heart disease complicated with pulmonary infection.Methods A total of 86 patients with coronary heart disease admitted to the hospital from July 2019 to July 2022 were enrolled in the study.According to whether they were complicated with pulmonary infection,they were divided into infection group(35 cases)and non-infection group(51 cases).In addition,50 healthy volunteers who underwent physical examination were enrolled as the control group.The differences of neutrophil CD64 index,TLR2 and TLR4 levels in the three groups were compared,and the correlation between CD64 index and TLR2 and TLR4 was analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of CD64 index,TLR2 and TLR4 in the diagnosis of coronary heart disease complicated with pulmonary infection.Results There were significant differences in CD64 index,TLR2 and TLR4 levels among the three groups(P<0.05).The infection group had significantly higher levels of the above indicators than the non-infection group and the control group(P<0.05).The above indicators in the non-infection group were higher than those in the control group(P<0.05).Pearson correlation analysis showed that both TLR2 and TLR4 were positively correlated with neutrophil CD64 index(P<0.05).The ROC curve showed that the area under the curve(AUC)of CD64 index,TLR2 and TLR4 for the diagnosis of coronary heart disease complicated with pulmonary infection was 0.922,0.929 and 0.662,respectively.CD64 index and TLR2 had high diagnostic efficiency.The sensitivity and specificity of CD64 index and TLR2 were 0.943,0.804 and 0.914,0.902,respectively.Conclusion The expression of neutrophil CD64,TLR2 and TLR4 is significantly increased in patients with coronary heart disease complicated with pulmonary infection.CD64 index and TLR2 have high diagnostic efficacy in coronary heart disease complicated with pulmonary infection.