冠心病PCI术后肺部感染外周血L-Arg/NOS/NO信号通路表达与其对预后的诊断价值

Expressions of L-Arg/NOS/NO signaling pathways in peripheral blood of coronary heart disease patients with pulmonary infection after PCI and values in diagnosis of prognosis

目的探究冠心病经皮冠状动脉介入治疗(PCI)术后肺部感染外周血L-精氨酸/一氧化氮合酶/一氧化氮(L-Arg/NOS/NO)信号通路表达与其对预后的诊断价值。方法去选取廊坊市第四人民医院2020年6月-2023年6月收治的187例冠心病PCI手术患者为研究对象,根据术后是否发生肺部感染分为感染组69例和非感染组118例,感染组患者根据30d预后情况分为良好预后组43例和不良预后组26例。统计感染组现况及病原菌分布;比较各组血小板L-Arg转运量、NOS活性、亚硝酸盐(NO2-)水平。采用受试者工作特征(ROC)曲线分析L-Arg、NOS、NO2对冠心病PCI术后肺部感染患者不良预后的诊断价值。结果果187例冠心病PCI手术患者术后肺部感染发生69例(36.90%),检出病原菌79株,以革兰阴性菌为主,主要为铜绿假单胞菌。感染组L-Arg、NOS、NO2水平低于非感染组(P<0.05),不良预后组L-Arg、NOS、NO2水平低于良好预后组(P<0.05)。L-Arg、NOS、NO2联合诊断冠心病PCI术后肺部感染患者不良预后曲线下面积(AUC)高于单一检测(P<0.05)。结论冠心病PCI术后肺部感染发生率高,病原菌以革兰阴性菌为主;冠心病PCI术后肺部感染患者及其不良预后L-Arg/NOS/NO信号通路表达异常,L-Arg、NOS、NO-联合检测可提高冠心病PCI术后肺部感染患者不良预后的诊断价值。

OBJECTIVE To explore the expressions of L-arginine/nitric oxide synthase/nitric oxide(L-Arg/NOS/NO)in peripheral blood of the coronary heart disease(CHD)patients with pulmonary infection after percutaneous coronary intervention(PCI)and analyze the values in diagnosis of the prognosis.METHODS A total of 187 CHD patients who underwent PCI in Langfang Fourth People's Hospital from Jun 2020 to Jun 2023 were recruited as the research subjects and were divided into the infection group with 69 cases and the non-infection group with 118 cases according to the status of postoperative pulmonary infection.The patients of the infection group were divided into the favorable prognosis group with 43 cases and the poor prognosis group with 26 cases according to the status of 30-day prognosis.The prevalence and etiological characteristics of the infection group were statistically analyzed.