住院AD并发肺部感染患者TLR4、NF-κB的表达及其预后评估价值

Expression and prognostic value of TLR4 and NF⁃κB in hospitalized patients with AD complicated with pulmonary infection

目的 探讨Toll样受体4(TLR4)、抑制核因子κB(NF-κB)在住院阿尔茨海默病(AD)并发肺部感染患者外周血中的表达及其预后价值。方法 选取2020年10月至2022年9月于邯郸市第一医院住院治疗的324例AD患者作为研究对象,根据是否并发肺部感染分为未感染组(214例)与感染组(110例),比较两组患者外周血TLR4、NF-κB水平。对AD并发肺部感染患者随访12个月,依据预后情况分为预后良好组(81例)和预后不良组(29)例,收集患者相关资料,对影响AD并发肺部感染患者预后进行单、多因素分析,绘制ROC曲线验证TLR4、NF-κB对其预后价值。结果 感染组患者外周血TLR4、NF-κB水平均高于未感染组,差异具有统计学意义(t=15.318、10.233,P均<0.05);预后不良组与预后良好组年龄、AD病程、是否有吸烟史、是否长期卧床、PSI评分、PCT、中性粒细胞、WBC计数、TLR4、NF-κB差异均具有统计学意义(χ^(2)/t=9.628、8.670、4.116、4.252、8.951、5.921、2.455、4.108、4.907、5.884,P均<0.05);Logistic回归分析结果显示:年龄、吸烟史、肺炎严重指数(PS)I评分、外周血TLR4、NF-κB水平为影响AD并发肺部感染患者预后的独立影响因素(P<0.05);ROC曲线结果显示:外周血TLR4、NF-κB及两项联合预测的AUC分别为0.828(0.742~0.914)、0.819(0.728~0.911)及0.900(0.841~0.959)(P均<0.05)。结论 AD患者外周血TLR4、NF-κB水平与患者并发肺部感染密切相关,外周血TLR4、NF-κB水平及两者联合对AD并发肺部感染患者预后具有良好预测效能。

Objective To investigate the expression and prognostic value of toll-like receptor 4(TLR4)and inhibitory nuclear factorκB(NF-κB)in peripheral blood of hospitalized patients with pulmonary infection in Alzheimer's disease(AD).Methods To investigate the expression and prognostic value of Toll-like receptor 4(TLR4)and inhibition of nuclear factorκB(NF-κB)in the peripheral blood of hospitalized pa-tients with pulmonary infections in Alzheimer's disease(AD),a total of 324 patients with AD hospitalized at Handan First Hospital from October 2020 to September 2022 were selected for the study.They were catego-rized into an uninfected group(214 cases)and an infected group(110 cases)based on the presence of pulmo-nary infection.The levels of TLR4 and NF-κB in the peripheral blood of both groups were compared.Patients with AD who were complicated by pulmonary infections were followed up for 12 months and further divided into a good prognosis group(81 cases)and a poor prognosis group(29 cases)based on their prognosis.Relevant pa-tient data was collected,and the prognostic value of TLR4 and NF-κB in patients with AD complicated by pul-monary infections was verified using ROC curves.Results The levels of TLR4 and NF-κB in the peripheral blood of the infected group were higher than those of the uninfected group,and the differences were statistically significant(t=15.318,10.233,P<0.05).There were significant differences between the poor prognosis group and the good prognosis group in age,duration of AD,smoking history,long-term bed rest,PSI score,PCT,neutrophil,WBC count,TLR4,and NF-κB(χ^(2)/t=9.628,8.670,4.116,4.252,8.951,5.921,2.455,4.108,4.907,5.884,P<0.05);Logistic regression analysis showed that age,smoking history,pneumonia severity in-dex(PSI)score,peripheral blood TLR4,and NF-κB levels were independent factors influencing the prognosis of patients with AD complicated by pulmonary infection(P<0.05).ROC curve results showed that the AUC of TLR4,NF-κB and the combined AUC were 0.828(0.742~0.914),0.819(0.728~0.911)and 0.900(0.841~0.959)in peripheral blood,respectively(P<0.05).Conclusion The levels of TLR4 and NF-κB in the peripher-al blood of AD patients are closely associated with pulmonary infections.The levels of TLR4 and NF-κB in the peripheral blood and their combination can predict the prognosis of AD patients with pulmonary infections.