急性心肌梗死并发肺部感染白细胞介素-23受体基因多态性及其危险因素

Interleukin-23 receptor gene polymorphisms in acute myocardial infarction patients complicated with pulmonary infection and risk factors

目的探索急性心肌梗死患者并发肺部感染与白细胞介素-23受体(IL-23R)基因多态性的关系及其危险因素。方法选择2019年9月-2023年7月安阳市人民医院收治的722例急性心肌梗死患者,根据患者经皮冠状动脉介入治疗后是否并发肺部感染分为感染组73例和非感染组649例,比较两组患者IL-23R基因多态性,采用Logistic回归分析急性心肌梗死患者合并肺部感染的危险因素。结果感染组患者IL-23R基因CC基因型占比(46.58%)高于非感染组(13.56%)(P<0.05);Logistic回归分析结果显示,IL-23R基因CC基因型、合并糖尿病、合并慢性阻塞性肺疾病、合并低蛋白血症、意识状态昏迷、气管插管及近1个月内连续使用抗菌药物均为急性心肌梗死患者并发肺部感染的危险因素(OR=2.793、2.192、2.452、3.019、2.452、3.536、2.445,P<0.05)。结论急性心肌梗死患者并发肺部感染与IL-23R基因CC基因型、合并糖尿病、合并慢性阻塞性肺疾病、合并低蛋白血症、意识状态昏迷、气管插管及近1个月内连续使用抗菌药物具有相关性。

OBJECTIVE To explore the association between the pulmonary infection in the patients with acute myocardial infarction and the interleukin-23 receptor(IL-23R)gene polymorphisms and analyze the risk factors.METHODS A total of 722 patients with acute myocardial infarction who were treated in Anyang People′s Hospital from Sep 2019 to Jul 2023 were enrolled in the study and were divided into the infection group with 73 cases and the non-infection group with 649 cases according to the status of pulmonary infection after percutaneous coronary interventional therapy.The IL-23R gene polymorphisms were compared between the two groups of patients.Logistic regression analysis was performed for the risk factors for the pulmonary infection in the myocardial infarction patients.RESULTS The proportion of patients with CC genotypes of IL-23R gene was significantly higher in the infection group(46.58%)than in the no infection group(13.56%)(P<0.05).The result of the logistic regression analysis showed that the CC genotype of IL-23R gene,complication with diabetes mellitus,complication with chronic obstructive pulmonary disease,complication with hypoproteinemia,consciousness state,endotracheal intubation and consecutive use of antibiotics within 1 month were the risk factors for the pulmonary infection in the patients with acute myocardial infarction(OR=2.793,2.192,2.452,3.019,2.452,3.536,2.445,P<0.05).CONCLUSION The pulmonary infection in the patients with acute myocardial infarction is associated with the CC genotypes of IL-23R gene,complication with diabetes mellitus,complication with chronic obstructive pulmonary disease(COPD),consciousness state of coma,endotracheal intubation and consecutive use of antibiotics within 1 month.