脑卒中患者CCR2和CRP水平与卒中相关性肺炎严重程度的关系及临床意义

Relationship and clinical significance between CCR2 and CRP levels and the severity of stroke associated pneumonia in stroke patients

目的检测脑卒中患者血清CC趋化因子受体2(CCR2)、C-反应蛋白(CRP)水平,分析二者与卒中相关性肺炎严重程度的关系及临床意义。方法选取2022年10月至2023年2月于该院诊治的78例卒中相关性肺炎患者作为研究组,根据肺炎严重程度将研究组患者分为轻度组(31例)、中度组(29例)和重度组(18例),另选取78例未并发肺炎的脑卒中患者作为对照组。采用Pearson法分析卒中相关性肺炎患者血清CCR2、CRP水平的相关性;采用多因素Logistic回归分析影响卒中相关性肺炎发生的因素;采用受试者工作特征(ROC)曲线分析血清CCR2、CRP对卒中相关性肺炎的诊断价值。结果研究组美国国立卫生研究院卒中量表(NIHSS)评分及血清CCR2、CRP水平均高于对照组(P<0.05);血清CCR2、CRP水平均随肺炎严重程度的增加而升高(P<0.05);研究组血清CCR2与CRP水平呈正相关(r=0.799,P<0.05);NIHSS评分、CCR2、CRP水平为脑卒中患者发生卒中相关性肺炎的危险因素(P<0.05);血清CCR2、CRP单独检测诊断卒中相关性肺炎的曲线下面积(AUC)分别为0.873、0.888,二者联合检测的AUC为0.936,二者联合检测优于血清CCR2、CRP单独检测(Z二者联合-CCR2=1.987、Z二者联合-CRP=1.832,P=0.041、0.047)。结论血清CCR2、CRP与卒中相关性肺炎的严重程度密切相关,二者联合检测对卒中相关性肺炎具有较高的诊断价值。

Objective To detect the serum levels of CC chemokine receptor 2(CCR2)and C-reactive protein(CRP)in stroke patients,and analyze their relationship with the severity of stroke associated pneumonia and their clinical significance.Methods A total of 78 patients with stroke associated pneumonia who were diagnosed and treated in the hospital from October 2022 to February 2023 were collected as the study group,according to the severity of pneumonia,the study group was divided into mild group(31 cases),moderate group(29 cases),and severe group(18 cases),78 stroke patients who did not develop pneumonia were included into control group.Pearson method was applied to analyze the correlation between serum CCR2 and CRP levels in stroke associated pneumonia patients.Multivariate Logistic regression was applied to analyze the factors influencing the occurrence of stroke associated pneumonia.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum CCR2 and CRP for stroke associated pneumonia.Results The National Institute of Health stroke scale(NIHSS)score,serum CCR2,and CRP levels in the study group were obviously higher than those in the control group(P<0.05).The levels of serum CCR2 and CRP increased with the aggravation of pneumonia(P<0.05).The levels of serum CCR2 and CRP in the study group were positively correlated(r=0.799,P<0.05).NIHSS score,CCR2,and CRP levels were risk factors for stroke associated pneumonia in stroke patients(P<0.05).The area under the curve(AUC)for the diagnosis of stroke associated pneumonia using serum CCR2 and CRP alone was 0.873 and 0.888,respectively,and the AUC for the combined detection of the two was 0.936,the combined detection of the two was superior to the individual detection of serum CCR2 and CRP(Z combination-CCR2=1.987,Z combination-CRP=1.832,P=0.041,0.047).Conclusion Serum CCR2 and CRP are closely related to the severity of stroke associated pneumonia,and their combined detection has high diagnostic value for stroke associated pneumonia.