血清信号转导抑制因子3、β防御素2对胸部创伤并发细菌感染诊断价值研究

Study on the diagnostic value of serum suppressors of cytokine signaling 3 andβ-defensin 2 in chest trauma complicated with bacterial infection

目的探讨血清细胞因子信号转导抑制因子3(SOCS3)、β防御素2(HBD2)对胸部创伤并发细菌感染的诊断价值。方法选取自2021年7月至2023年12月收治的胸部创伤(包括以胸部创伤为主的多发伤)患者152例为创伤组,并根据其是否并发细菌感染分为感染组(n=53)和无感染组(n=99),另选取同期在本院进行健康体检的志愿者152例为健康组。采用酶联免疫吸附法检测血清SOCS3、HBD2水平;采用Pearson相关分析感染组血清SOCS3与HBD2水平的相关性;采用多因素Logistic回归分析(逐步向前法)影响胸部创伤患者并发细菌感染的因素;采用受试者工作特征曲线分析血清SOCS3、HBD2对胸部创伤患者并发细菌感染的诊断价值,并采用Z检验比较其曲线下面积(AUC)。结果创伤组血清SOCS3、HBD2水平明显高于健康组,差异有统计学意义(P<0.05)。感染组创伤严重程度评分(ISS)、机械通气时间明显高于无感染组,差异有统计学意义(P<0.05)。感染组血清SOCS3、HBD2水平明显高于无感染组,差异有统计学意义(P<0.05)。感染组血清SOCS3与HBD2水平呈正相关(r=0.579,P<0.05)。SOCS3、HBD2、ISS评分是影响胸部创伤患者并发细菌感染的因素(P<0.05)。血清SOCS3、HBD2联合诊断胸部创伤患者并发细菌感染的AUC为0.920(95%可信区间:0.878~0.961),SOCS3、HBD2单独诊断胸部创伤患者并发细菌感染的AUC分别为0.830(95%可信区间:0.763~0.897)、0.811(95%可信区间:0.741~0.881),二者联合诊断效能较SOCS3(Z=2.252,P=0.024)、HBD2(Z=2.615,P=0.009)单独诊断效能更高。结论胸部创伤并发细菌感染患者血清SOCS3、HBD2水平异常升高,二者联合诊断胸部创伤患者并发细菌感染的价值较高。

Objective To analyze the diagnostic value of serum suppressors of cytokine signaling 3(SOCS3)andβ-defensin 2(HBD2)in chest trauma complicated with bacterial infection.Methods A total of 152 patients with chest trauma(including multiple injuries mainly caused by chest trauma)admitted from July 2021 to December 2023 were selected as the traumatology group.They were grouped into a infection group(n=53)and a non infection group(n=99)based on whether they were complicated with bacterial infection,in addition,152 volunteers who underwent health checkups in our hospital during the same period were selected as the healthy group.The serum levels of SOCS3 and HBD2 were detected using enzyme-linked immunosorbent assay.The correlation between serum SOCS3 and HBD2 levels in the infection group was analyzed using Pearson correlation analysis.The factors affecting the concurrent bacterial infection in patients with chest trauma were analyzed using multivariate Logistic regression(stepforward method).The diagnostic value of serum SOCS3 and HBD2 for bacterial infections in patients with chest trauma was analyzed using receiver operating characteristic curve analysis,and Z-test was used to compare the area under the curve(AUC).Results The serum levels of SOCS3 and HBD2 in the traumatology group were obviously higher than those in the healthy group,and the difference was statistically significant(P<0.05).The injury severity score(ISS)and mechanical ventilation time in the infection group were obviously higher than those in the non infection group,and the difference was statistically significant(P<0.05).The levels of SOCS3 and HBD2 in the infection group were obviously higher than those in the non infection group,and the difference was statistically significant(P<0.05).The serum SOCS3 and HBD2 levels in the infection group were positively correlated(r=0.579,P<0.05).SOCS3,HBD2,and ISS scores were factors influencing concurrent bacterial infections in patients with chest trauma(P<0.05).The AUC for the combined diagnosis of serum SOCS3 and HBD2 in patients with chest trauma complicated by bacterial infection was 0.920[95%conticlence interval(CI)0.878-0.961],the AUC of SOCS3 and HBD2 in diagnosing chest trauma patients with concurrent bacterial infections was 0.830(95%CI:0.763-0.897)and 0.811(95%CI:0.741-0.881),respectively,the combined diagnostic efficacy of the two was higher than that of SOCS3(Z=2.252,P=0.024)and HBD2(Z=2.615,P=0.009)alone.Conclusion The serum levels of SOCS3 and HBD2 in patients with chest trauma complicated by bacterial infection are abnormally elevated,and the combined diagnosis of the two has high value in the diagnosis of bacterial infection in chest trauma patients.