脑卒中患者肺部感染病原学及外周血miRNA的诊断价值

Etiological characteristics of pulmonary infection in stroke patients and diagnostic value of peripheral blood miRNA

目的研究脑卒中患者发生肺部感染的病原学特征及外周血微小核糖核酸-193b(miR-193b)、微小核糖核酸-127(miR-127)、微小核糖核酸-133(miR-133)的诊断价值。方法选取2020年1月-2022年12月徐州市第一人民医院收治的469例脑卒中患者,依据是否发生肺部感染分为感染组116例和未感染组353例,分析脑卒中患者发生肺部感染的现状及病原学特征,检测外周血miR表达水平,受试者工作特征(ROC)曲线分析其对肺部感染的预测价值。结果脑卒中患者肺部感染发生率为24.73%(116/469),感染的主要病原菌种类为肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌、肺炎链球菌和白假丝酵母;感染组外周血miR-193b、miR-127、miR-133表达水平高于未感染组(P<0.05),并随感染程度加重表达水平呈逐渐升高趋势(P<0.05);外周血miR-193b、miR-127、miR-133联合预测脑卒中患者肺部感染的曲线下面积(AUC)值、敏感度和特异度分别为0.877、85.34%和77.05%。结论脑卒中患者肺部感染发生率较高,肺部感染的发生可引起脑卒中患者外周血miR-193b、miR-127、miR-133表达水平升高,三者联合对脑卒中患者肺部感染的发生具有较好的预测价值。

OBJECTIVE To investigate the etiological characteristics of pulmonary infection in the stroke patients and analyze the diagnostic values of peripheral blood micro ribonucleic acid-193b(miR-193b),micro ribonucleic acid-127(miR-127)and micro ribonucleic acid-133(miR-133).METHODS A total of 469 stroke patients who were treated in Xuzhou First People′s Hospital from Jan 2020 to Dec 2022 were enrolled in the study and were divided into the infection group with 116 cases and the no infection group with 353 cases according to the status of pulmonary infection.The current status and etiological characteristics of the pulmonary infection were analyzed,the expression levels of peripheral blood miR were detected,and the values in prediction of the pulmonary infection were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The incidence of pulmonary infection was 24.73%(116/469)among the stroke patients.Klebsiella pneumoniae,Pseudomonas aeruginosa,Staphylococcus aureus,Streptococcus pneumoniae and Candida albicans were the major species of pathogens causing the infection.The expression levels of peripheral blood miR-193b,miR-127 and miR-133 of the infection group were significantly higher than those of the no infection group(P<0.05),which showed upward trends with the aggravation of the infection(P<0.05).The area under curve(AUC)of the joint detection of peripheral blood miR-193b,miR-127 and miR-133 was 0.877 in prediction of the pulmonary infection in the stroke patients,with the sensitivity 85.34%,the specificity 77.05%.CONCLUSION The incidence of pulmonary infection is high among the stroke patients,the pulmonary infection may result in the rise of expression levels of peripheral blood miR-193b,miR-127 and miR-133,and the joint detection of the three indexes has high value in prediction of the pulmonary infection in the stroke patients.