慢性心衰合并肺部感染病原菌与危险因素及其血清miRNA-21水平

Pathogenic bacteria and risk factors for pulmonary infections in chronic heart failure and expression of serum miRNA-21

目的 分析慢性心衰合并肺部感染患者病原菌与危险因素及血清微小核糖核酸-21(miRNA-21)表达水平.方法 选择2020年5月-2022年5月河南省人民医院收治的130例慢性心衰患者纳入研究,根据患者肺部感染情况将其分为感染组25例,未感染组105例;分析慢性心衰合并肺部感染的病原菌及两组血清miRNA-21水平,分析两组患者临床资料,归纳慢性心衰合并肺部感染的危险因素.结果 130例慢性心衰患者肺部感染25例,感染率为19.23%;25例慢性心衰合并肺部感染患者共培养分离病原菌32株,其中革兰阴性菌23株占71.88%,革兰阳性菌8株占25.00%,真菌1株占3.13%;将单因素分析具有统计学意义的指标作为自变量,慢性心衰合并肺部感染情况作为因变量,多因素Logistic分析结果显示,侵入性操作、血清miRNA-21水平升高是慢性心衰患者肺部感染的危险因素(P<0.05).结论 慢性心衰合并肺部感染主要病原菌为革兰阴性菌,miRNA-21 可能参与疾病发展,慢性心衰患者肺部感染的易感因素能作为临床预防措施制定的依据.

OBJECTIVE To analyze the distribution of pathogenic bacteria,risk factors and serum expression levels of microRNA-21(miRNA-21)in patients with chronic heart failure complicated with pulmonary infection.METHODS A total of 130 patients with chronic heart failure admitted to Henan Provincial People's Hospital from May 2020 to May 2022 were selected for inclusion in the study and were divided into 25 cases of the infected group and 105 cases of the uninfected group according to the patients'pulmonary infection.The pathogenic bacteria of chronic heart failure complicated with lung infection and the serum mRNA-21 level of the two groups were analyzed,the clinical data of the two groups were analyzed,and the risk factors of chronic heart failure complicated with lung infection were summarized.RESULTS There were 25 cases of pulmonary infection in 130 patients with chronic heart failure,with an infection rate was 19.23%.A total of 32 strains of pathogenic bacteria were isolated from 25 patients with chronic heart failure complicated with pulmonary infection,of which 23 strains of gram-neg ative bacteria accounted for 71.88%.8 strains of gram-positive bacteria accounted for 25.00%and 1 strain of fungus accounted for 3.13%.Using the statistically significant indicators of univariate analysis as independent variables and the status of chronic heart failure combined with pulmonary infection as dependent variables,multivariate logistic analysis showed that invasive operations,elevated serum miRNA-21 levels were risk factors for pulmonary infection in patients with chronic heart failure(P<0.05).CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the chronic neart failure patients with pulmonary infection,with gram-negative bacteria as the main pathogens.MicroRNA-21 might be involved in the development of the disease,and the susceptibility factors for pulmonary infection in patients with chronic heart failure could be used as a basis for the development of clinical preventive measures.