老年CHF合并肺部感染患者病原菌分布及TGF-β1/Smads信号通路表达

Pathogenic distribution and expressions of TGF-β1/Smads signaling pathways in elderly patients with CHF and pulmonary infection

目的探究老年慢性心力衰竭(CHF)合并肺部感染患者病原菌分布及转化生长因子β1(TGF-β1)/信号传导蛋白Smads(Smads)信号通路表达。方法选取2021年1月-2021年6月唐山市工人医院收治的老年CHF合并肺部感染患者100例为感染组;另选取医院同期收治的单纯老年CHF患者100例作为对照组。收集所有研究对象的临床资料,对病原菌进行鉴定,比较两组TGF-β1、Smad2、Smad3蛋白表达水平及血清TGF-β1、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平;采用Spearman相关性分析老年CHF合并肺部感染患者TGF-β1/Smads信号通路相关蛋白表达水平与其纽约心脏协会(NYHA)心功能分级之间的相关性。结果感染组患者共分离出病原菌118株,其中革兰阴性菌69株(58.47%),革兰阳性菌40株(33.90%),真菌9株(7.63%);感染组患者的TGF-β1、Smad2、Smad3蛋白表达水平及血清TGF-β1、TNF-α及IL-8水平高于对照组(P<0.05);心功能Ⅰ~Ⅱ级组患者的TGF-β1、Smad2、Smad3蛋白表达水平低于心功能Ⅲ~Ⅳ级组(P<0.05);相关性分析结果显示,老年CHF合并肺部感染患者的TGF-β1、Smad2、Smad3蛋白表达水平与其NYHA分级呈正相关关系(P<0.05)。结论老年CHF合并肺部感染患者的病原菌以革兰阴性菌为主,其TGF-β1/Smads信号通路可能被过度激活,且可能与患者心功能存在一定关系。

OBJECTIVE To explore pathogenic distribution and expressions of transforming growth factor betal(TGF-β1)/signal transducer protein Smads(Smads)signaling pathways in elderly patients with chronic heart failure(CHF)and pulmonary infection.METHODS A total of 100 elderly patients with CHF and lung infection admitted to Tangshan Workers′Hospital between Jan and Jun 2021 were enrolled as the infection group,and another 100 elderly patients with CHF and without lung infection during the same period were enrolled as the control group.The clinical data of all patients were collected and pathogens were detected.The protein expression levels of TGF-β,Smad2 and Smad3,and serum levels of TGF-β1,interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)between the two groups were compared.The correlation between the expression levels of TGF-β1/Smads signaling pathway-related proteins and cardiac function grading in New York Heart Association(NYHA)was analyzed by Spearman correlation analysis.RESULTS Total of 118 strains of pathogens in the infection group were isolated,including 69 strains(58.47%)of gram-negative bacteria,40 strains(33.90%)of gram-positive bacteria and 9 strains(7.63%)of fungi.The protein expression levels of TGF-β1,Smad2 and Smad3,and serum levels of TGF-β1,TNF-α and IL-8 in the infection group were higher than those in the control group(P<0.05).The expression levels of TGF-β1,Smad2 and Smad3 in the grade Ⅰ-Ⅱ group were lower than those in the grade Ⅲ-Ⅳ group(P<0.05).Correlation analysis showed that the expression levels of TGF-β1,Smad2 and Smad3 were positively correlated with NYHA grading(P<0.05).CONCLUSION Gram-negative bacteria is the main pathogen in elderly patients with CHF and lung infection.TGF-β1/Smads signaling pathways may be over-activated,which may be related to impaired cardiac function.