外周血HMGB1、IL-17水平与急性心力衰竭伴上呼吸道感染的关系

Relationship Between Peripheral Blood HMGB1,IL-17 and Acute Heart Failure Combined with Upper Respiratory Tract Infection

目的探究外周血高迁移率族蛋白1(HMGB1)、白细胞介素-17(IL-17)水平与急性心力衰竭(AHF)伴上呼吸道感染关系。方法选择2020年3月至2022年7月来河南大学第一附属医院就诊的AHF伴上呼吸道感染患者80例作为感染组,选取AHF未伴呼吸道感染患者45例作为未感染组。比较两组外周血HMGB1、IL-17、脑钠肽(BNP)、心肌酶谱指标[肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)和肌酸激酶(CK)]及超声心动图指标,采用Pearson相关性分析了解外周血HMGB1、IL-17水平与BNP、心肌酶谱、超声心动图指标关系。根据28 d内感染组中疾病转归情况,分为预后不良(n=54)与预后良好组(n=26),比较两组外周血HMGB1、IL-17水平,探究HMGB1、IL-17与疾病转归的关系。结果感染组外周血HMGB1、IL-17、BNP、LDH、CK、CK-MB水平均高于未感染组(P<0.05);感染组LAD、LVEDD水平均高于未感染组(P<0.05),感染组LVEF水平低于未感染(P<0.05);外周血HMGB1、IL-17与BNP、LDH、CK、CK-MB、LAD、LVEDD水平均呈正相关(P<0.05),外周血HMGB1、IL-17与LVEF水平呈负相关(P<0.05);AHF伴上呼吸道感染患者中预后良好组的外周血HMGB1、IL-17水平均低于预后不良组,心功能分级中Ⅱ级比率高于预后不良组(P<0.05);采用受试者工作特征(ROC)曲线分析,两项指标联合预测AHF伴上呼吸道感染患者预后不良的曲线下面积(AUC)为0.876,均高于单一HMGB1、IL-17(0.827、0.801)。结论外周血HMGB1、IL-17水平与AHF发生上呼吸道感染相关,两者联合检测对AHF伴有上呼吸道感染患者预后评估价值更高。

Objective To explore the relationship between peripheral blood high mobility group box 1(HMGB1),interleukin-17(IL-17)and acute heart failure(AHF)combined with upper respiratory tract infection.Methods A total of 80 patients with AHF and upper respiratory tract infection treated in the First Affiliated Hospital of Henan University were enrolled as infection group between March 2020 and July 2022,while 45 AHF patients without upper respiratory tract infection were enrolled as non-infection group.The peripheral blood HMGB1,IL-17,brain natriuretic peptide(BNP),myocardial enzymes[creatine kinase-MB(CK-MB),lactate dehydrogenase(LDH),creatine kinase(CK)]and ultrasonic cardiogram indexes were compared between the two groups.The relationship between HMGB1,IL-17 and BNP,myocardial enzymes,ultrasonic cardiogram indexes was analyzed by Pearson correlation analysis.According to disease outcomes within 28 days,patients in infection group were divided into poor prognosis group(n=54)and good prognosis group(n=26),and levels of HMGB1 and IL-17 between the two groups were compared.The relationship between HMGB1,IL-17 and disease outcomes was explored.Results The levels of peripheral blood HMGB1,IL-17,BNP,LDH,CK and CK-MB in infection group were higher than those in non-infection group(P<0.05).The levels of LAD and LVEDD in infection group were higher than those in non-infection group(P<0.05),while LVEF was lower than that in non-infection group(P<0.05).The levels of peripheral blood HMGB1 and IL-17 were positively correlated with BNP,LDH,CK,CK-MB,LAD and LVEDD levels(P<0.05),while negatively correlated with LVEF(P<0.05).The levels of peripheral blood HMGB1 and IL-17 in good prognosis group were lower than those in poor prognosis group,and proportion of cases with cardiac function grading at gradeⅡwas higher than that in poor prognosis group(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that area under the curve(AUC)of HMGB1 combined with IL-17 for predicting poor prognosis was 0.876,greater than that of HMGB1 and IL-17 alone(0.827,0.801).Conclusion The levels of peripheral blood HMGB1 and IL-17 are correlated with upper respiratory tract infection in AHF,and combined detection of the two indexes has higher prognostic value.