血清CC16、Tim-3对老年多重耐药菌血流感染预后的预测价值分析

Analysis of the predictive value of serum CC16 and Tim-3 for the prognosis of elderly patients with multi-drug-resistant bacterial bloodstream infections

目的探究血清Clara细胞蛋白16(CC16)、T淋巴细胞免疫球蛋白黏蛋白分子-3(Tim-3)对老年多重耐药菌血流感染患者预后的预测价值。方法本研究通过选取2020年1月-2022年12月在本院治疗的老年多重耐药菌血流感染患者(80例)作为血流感染组,取同期在本院体检健康者(80例)作对照组,比较两组血清CC16、Tim-3水平;根据患者的预后情况将其分为生存组和死亡组,比较两组一般资料以及血清CC16、Tim-3水平。ROC分析血清CC16、Tim-3水平对血流感染患者预后的预测价值。Logistic分析影响血流感染患者预后的因素。结果血流感染组血清CC16水平比对照组低,Tim-3水平比对照组高(P<0.05)。死亡组血清CC16水平比生存组低,Tim-3、白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)水平比生存组高(P<0.05)。血清CC16、Tim-3联合预测血流感染患者死亡的AUC为0.920(95%CI:0.856~0.984),高于其单独检测(Z=2.571、2.915,P<0.05),灵敏度77.80%,特异度85.50%。Logistic回归模型分析显示,Tim-3是影响血流感染患者死亡的危险因素,CC16是保护因素(P<0.05)。结论血清CC16、Tim-3对老年多重耐药菌血流感染患者的预后有一定的预测价值,可能是评估患者预后情况的潜在指标。

Objective To explore the predictive value of serum Clara cell protein 16(CC16)and T cell immunoglobulin domain and mucin domain-3(Tim-3)on the prognosis of elderly patients with multidrug-resistant bacterial bloodstream infections.Methods This study selected 80 elderly patients with multidrug-resistant bacterial bloodstream infections who were treated in our hospital from January 2020 to December 2022 as the bloodstream infection group,and 80 healthy individuals who underwent physical examination in our hospital as the control group.The serum levels of CC16 and Tim-3 were compared between the two groups.According to the prognosis,they were separated into survival group and death group.The general information and serum levels of CC16 and Tim-3 were compared between the two groups.ROC was applied to analyze the predictive value of serum CC16 and Tim-3 levels on the prognosis of patients with bloodstream infections.Logistic was applied to analyze the factors affecting the prognosis of patients with bloodstream infections.Results The serum CC16 level in the bloodstream infection group was lower than that in the control group,and the Tim-3 level was higher than that in the control group(P<0.05).The serum CC16 level in the death group was lower than that in the survival group,while the levels of Tim-3,white blood cell count(WBC),C-reactive protein(CRP),and procalcitonin(PCT)were higher than those in the survival group(P<0.05).The combined prediction of serum CC16 and Tim-3 for death in patients with bloodstream infection had an AUC of 0.920(95%CI:0.856-0.984),which was higher than its individual detection(Z=2.571,2.915,P<0.05),with a sensitivity of 77.80%and a specificity of 85.50%.Logistic regression model analysis showed that Tim-3 was a risk factor for death in patients with bloodstream infections,and CC16 was a protective factor(P<0.05).Conclusion Serum CC16 and Tim-3 have certain predictive value for the prognosis of elderly patients with multidrug-resistant bacterial bloodstream infection,and may be potential indicators for evaluating prognosis.