血清hs-CRP、HMGB1、sTREM-1与革兰阴性菌肺部感染患者亚胺培南治疗效果的关系

Relationship between serum hs⁃CRP、HMGB1、sTREM⁃1 and therapeutic effect of imipenem in patients with Gram⁃negative bacterial pulmonary infection

目的 分析研究血清超敏C-反应蛋白(hs-CRP)、高迁移率族蛋白B1(HMGB1)与可溶性人髓系细胞触发受体-1(sTREM-1)与革兰阴性菌肺部感染患者亚胺培南治疗效果的关系。方法 选取2021年1月至2023年4月安徽省和县人民医院收治的100例革兰阴性菌肺部感染患者作为研究对象,对患者使用亚胺培南治疗7 d,根据治疗效果将患者分为有效组(n=71)与无效组(n=29)。比较两组治疗前后的hs-CRP、HMGB1与sTREM-1水平;采用多因素Logistic回归分析革兰阴性菌肺部感染患者亚胺培南治疗效果的影响因素,并绘制ROC曲线分析治疗前血清hs-CRP、HMGB1、sTREM-1水平对革兰阴性菌肺部感染患者亚胺培南治疗效果的预测价值。结果 有效组治疗前的血清hs-CRP、HMGB1、sTREM-1水平均低于无效组,差异均具有统计学意义(t=8.125、6.111、5.863,均P<0.05);有效组治疗后的血清hs-CRP、HMGB1、s TREM-1水平均低于无效组,差异均具有统计学意义(t=9.469、11.563、9.607,均P<0.05);多因素Logistic回归分析显示,治疗前hs-CRP水平升高(OR=1.941)、HMGB1水平升高(OR=2.100)及sTREM-1水平升高(OR=1.972)均是革兰阴性菌肺部感染患者亚胺培南治疗效果的独立危险因素(P<0.05);ROC曲线分析显示,治疗前血清hs-CRP、HMGB1、sTREM-1水平及联合评估革兰阴性菌肺部感染患者亚胺培南治疗效果优于单一检测(P<0.05)。结论 血清hs-CRP、HMGB1、sTREM-1水平与革兰阴性菌肺部感染患者亚胺培南治疗效果密切相关。

Objective To investigate the relationship between serum high sensitivity C⁃reactive protein(hs⁃CRP),high mobility group protein B1(HMGB1)and soluble triggering receptor expressed on hu⁃man myeloid cells⁃1(sTREM⁃1)and the therapeutic effect of imipenem in patients with Gram⁃negative bacteri⁃al pulmonary infection.Methods A total of 100 patients with pulmonary infections caused by Gram⁃negative bacteria were admitted to the Peoples Hospital of Anhui Province from January 2021 to April 2023 and were se⁃lected as the subjects of the study.These patients were treated with imipenem for 7 days and were then divided into two groups based on treatment effectiveness:the effective group(n=71)and the ineffective group(n=29).The levels of hs⁃CRP,HMGB1 and sTREM⁃1 before and after treatment were compared between the two groups.Multivariate logistic regression was used to analyze the factors that affect the therapeutic effect of imipe⁃nem in patients with Gram⁃negative bacterial pulmonary infections.Additionally,an ROC curve was drawn to analyze the predictive value of serum hs⁃CRP,HMGB1 and sTREM⁃1 levels before treatment on the therapeutic effect of imipenem in patients with Gram⁃negative bacterial pulmonary infections.Results The levels of serum hs⁃CRP,HMGB1 and sTREM⁃1 in the effective group before treatment were lower than those in the ineffective group,with statistical significance(t=8.125,6.111,5.863,P<0.05).After treatment,the levels of serum hs⁃CRP,HMGB1 and sTREM⁃1 in the effective group were also lower than those in the ineffective group,with statis⁃tically significant differences(t=9.469,11.563,9.607,P<0.05).Multivariate logistic regression analysis showed that the increase of hs⁃CRP level(OR=1.941),HMGB1 level(OR=2.100)and sTREM⁃1 level(OR=1.972)be⁃fore treatment were independent risk factors for the treatment effect of imipenem in patients with Gram⁃negative bacterial pulmonary infection(P<0.05).Furthermore,ROC curve analysis demonstrated that the levels of serum hs⁃CRP,HMGB1 and sTREM⁃1 before treatment had area showing that combined detection was superior to sin⁃gle detection(P<0.05).Conclusion Serum levels of hs⁃CRP,HMGB1 and sTREM⁃1 were found to be closely related to the therapeutic effects of imipenem in patients with Gram⁃negative bacterial pulmonary infections.