ICU重症颅脑损伤术后肺部感染病原菌与血清HMGB1、ICAM-1、miR-126、miR-16表达及其意义

Pathogens causing postoperative pulmonary infections and expressions of serum HMGB1,ICAM-1,miR-126 and miR-16 in ICU patients with severe craniocerebral injury

目的探究重症监护室(ICU)重症颅脑损伤术后肺部感染病原菌与血清高迁移率族蛋白B1(HMGB1)、细胞间黏附分子-1(ICAM-1)、微小核糖核酸(miR)-126、miR-16表达及其意义。方法选取2022年1月-2023年1月中国医科大学附属盛京医院收治的ICU重症颅脑损伤95例患者为研究对象,根据术后肺部感染情况分为感染组34例、非感染组61例。比较两组血清HMGB1、ICAM-1、miR-126、miR-16水平,统计感染组病原菌分布,分析HMGB1、ICAM-1、miR-126、miR-16对ICU重症脑损伤术后肺部感染的预测价值。结果感染组共检出45株病原菌,革兰阴性菌占比最高,以肺炎克雷伯菌为主。感染组血清miR-126水平较非感染组低,血清HMGB1、ICAM-1、miR-16水平较非感染组高(P<0.05),四指标联合检测诊断ICU重症颅脑损伤术后肺部感染的曲线下面积(AUC)比各指标单一检测均高(P<0.05),敏感度为91.18%、特异度为88.52%。结论ICU重症颅脑损伤术后肺部感染多为革兰阴性菌感染,血清HMGB1、ICAM-1、miR-16水平高表达、miR-126水平低表达,联合检测可提高其预测价值。

OBJECTIVE To explore the pathogens causing postoperative pulmonary infection and expressions of ser-um high mobility group protein BI(HMGB1),intercellular adhesion molecule-1(ICAM-1),microribonucleic acid(miR)-126 and miR-16 in intensive care unit(ICU)patients with severe craniocerebral injury and analyze the sig-nificance.METHODS A total of 95 patients with severe craniocerebral injury who were treated in ICU of Shengjing Hospital Affiliated to China Medical University from Jan 2022 to Jan 2023 were recruited as the research subjects and were divided into the infection group with 34 cases and the non-infection group with 61 cases according to the status of pulmonary infection.The levels of serum HMGB1,ICAM-1,miR-126 and miR-16 were compared be-tween the two groups.The distribution of pathogens isolated from the infection group was statistically analyzed.The values of HMGBl,ICAM-1,miR-126 and miR-16 in prediction of postoperative pulmonary infection in the ICU patients with severe craniocerebral injury were analyzed.RESULTS Totally 45 strains of pathogens were isolated from the infection group,among which gram-negative bacteria were dominant,and Klebsiella pneumoniae was the predominant species.The serum miR-126 level of the infection group was lower than that of the non-infection group,while the levels of serum HMGBl,ICAM-1 and miR-16 of the infection group were higher than those of the non-infection group(P<0.05).The area under curve(AUC)of the joint detection of the four indexes was higher than that of the single index in diagnosis of the postoperative pulmonary infection of the ICU patients with severe craniocerebral injury(P<0.05),with the sensitivity 91.18%,the specificity 88.52%.CONCLUSION The patients with gram-negative bacteria infections are dominant among the ICU severe craniocerebral injury patients with postoperative pulmonary infection,the patients show the high expression levels of serum HMGBl,ICAM-1 and miR-16 and the low expression level of miR-126.The joint detection may raise the predictive value.