急性缺血性脑卒中病人血清降钙素原、白细胞介素-33及25-羟维生素D水平与卒中相关性肺炎的关系研究

Relationships between serum PCT,IL-33 and 25-(OH)D levels and stroke-associated pneumonia in patients with acute ischemic stroke

目的探讨急性缺血性脑卒中(AIS)病人血清降钙素原(PCT)、白细胞介素-33(IL-33)、25-羟维生素D[25-(OH)]D水平与卒中相关性肺炎(SAP)的关系。方法选取2020年5月至2022年4月郑州大学第一附属医院重症监护病区AIS病人200例,根据入重症监护病区72 h内是否发生SAP分为SAP组(78例)与非SAP组(122例)。统计并比较两组一般资料[性别、年龄、身体质量指数(BMI)、入院时格拉斯哥昏迷量表(GCS)评分、高血压、糖尿病、高脂血症]以及血清PCT、IL-33、25-(OH)D水平。采用logistic回归分析AIS病人并发SAP的影响因素,受试者操作特征曲线(ROC曲线)分析血清PCT、IL-33及25-(OH)D及联合检测对SAP的诊断效能。结果SAP组血清25-(OH)D水平低于非SAP组,血清PCT、IL-33水平高于非SAP组,均差异有统计学意义(P<0.05);logistic回归分析显示PCT、IL-33、25-(OH)D是AIS病人并发SAP的影响因素(P<0.05);ROC曲线显示血清PCT、IL-33、25-(OH)D及联合检测AIS病人并发SAP的AUC分别为0.93[95%CI:(0.89,0.96)]、0.93[95%CI:(0.89,0.96)]、0.90[95%CI:(0.85,0.93)]、0.99[95%CI:(0.97,1.00)],联合检测时预测效能较高。结论血清PCT、IL-33、25-(OH)D水平对AIS病人并发SAP具有早期诊断价值,联合检测可提高SAP的诊断效能。

Objective To investigate the relationships between serum levels of procalcitonin(PCT),interleukin-33(IL-33),and 25-hydroxyvitamin D(25-(OH)D)and stroke-associated pneumonia(SAP)in patients with acute ischemic stroke(AIS).Methods A total of 200 AIS patients from May 2020 to April 2022 were selected from the intensive care wards of the First Affiliated Hospital of Zhengzhou University and divided into the SAP group(78 patients)and the non-SAP group(122 patients)according to whether SAP occurred within 72 h of admission to the intensive care ward.The general information[sex,age,body mass index(BMI),Glasgow Coma Scale(GCS)score on admission,hypertension status,diabetes status,hyperlipidemia status]and serum PCT,IL-33,and25-(OH)D levels of the two groups were statistically and comparatively analyzed.Logistic regression was used to analyze the influencing factors of AIS patients complicated with concurrent SAP,and receiver operating characteristic(ROC)curves were used to analyze the diagnostic efficacy of serum PCT,IL-33 and 25-(OH)D and the combined detection of SAP.Results The serum 25-(OH)D level in the SAP group was lower than that in the non-SAP group,and the serum PCT and IL-33 levels were significantly greater than those in the non-SAP group,and all the difference were statistically significant(P<0.05).Logistic regression revealed showed that PCT,IL-33 and 25-(OH)D were the influencing factors for AIS patients complicated with SAP(P<0.05).ROC curves showed that the AUCs of serum PCT,IL-33,and 25-(OH)D and the combined detection of AIS patients complicated with SAP were 0.93[95%CI:(0.89,0.96)],0.93[95%CI:(0.89,0.96)],0.90[95%CI:(0.85,0.93)],and 0.99[95%CI:(0.97,1.00)],respectively,and the predictive efficacy was greater with combined detection.Conclusion The serum PCT,IL-33 and 25-(OH)D levels have early diagnostic value in AIS patients complicated with SAP,and the combined detection can improve the diagnostic efficacy of SAP.