血清NF-κB和TLR4及u-mAlb在尿路感染患者中的表达水平及意义

Expression and significance of serum NF⁃κB,TLR4 and u⁃mAlb in patients with urinary tract infection

目的探讨尿路感染患者血清中核因子κB(NF-κB)、Toll样受体4(TLR4)及尿微量白蛋白(u-mAlb)的表达水平,及其对临床诊疗的意义。方法选择2018年6月-2022年5月于彭水苗族土家族自治县人民医院进行治疗的239例尿路感染患者进行研究,设为感染组,根据有无临床症状分为有症状组109例和无症状组130例。并选择同期体检的170名健康人作为对照组,分析血清NF-κB、TLR4及u-mAlb水平变化情况及其预测价值。结果感染组血清NF-κB、TLR4及u-mAlb水平高于对照组,差异均有统计学意义(t=10.511、17.805、29.245,P均<0.05)。有症状组患者血清NF-κB、TLR4及u-mAlb水平显著高于无症状组患者,差异均有统计学意义(t=4.767、11.387、5.887,P均<0.05)。受试者工作特征(ROC)曲线结果显示,血清NF-κB预测尿路感染的曲线下面积(AUC)为0.788,敏感度为84.56%,特异度为83.26%,截断值为59.67 pg/mL;血清TLR4预测尿路感染的AUC为0.898,敏感度85.17%,特异度为84.20%,截断值为63.24 pg/mL;血清u-mAlb预测尿路感染的AUC为0.671,敏感度为83.18%,特异度为84.16%,截断值为34.42 mg/L。结论血清NF-κB、TLR4及u-mAlb在尿路感染患者中表达异常,有利于尿路感染的早期诊断。

Objective To study the expression and clinical significance of serum nuclear factor kappa⁃B(NF⁃κB),Toll⁃like receptor⁃4(TLR4)and urinary microalbumin(u⁃mAlb)in patients with urinary tract infection.Methods A total of 239 patients with urinary tract infections treated in the Pengshui Miao Tujia Autonomous County People's Hospital from June 2018 to May 2022 were enrolled as the infected group,according to the presence of clinical symptoms,109 patients were classified in the symptomatic group and 130 patients in the asymptomatic group,and 170 healthy subjects were selected as the control group for the analysis of the changes of serum NF⁃κB,TLR4 and u⁃mAlb levels and their predictive value.Results The levels of NF⁃κB,TLR4 and u⁃mAlb in infected group were significantly higher than those in control group,the differences were statistically significant(t=10.511,17.805,29.245;all P<0.05).The levels of serum NF⁃κB,TLR4 and u⁃mAlb in symptomatic group were significantly higher than those in asymptomatic group,the differences were statistically significant(t=4.767,11.387,5.887;all P<0.05).Receiver operating characteristic(ROC)results showed that the area under the curve(AUC)of serum NF⁃κB for predicting urinary tract infection was 0.788,the sensitivity was 84.56%,the specificity was 83.26%,and the cut⁃off value was 59.67 pg/mL.The AUC of serum TLR4 predicting urinary tract infection was 0.898,the sensitivity was 85.17%,the specificity was 84.20%,and the cut⁃off value was 63.24 pg/mL.The AUC of serum u⁃mAlb for predicting urinary tract infection was 0.671,the sensitivity was 83.18%,the specificity was 84.16%,and the cut⁃off value was 34.42 mg/L.Conclusion Expression of serum NF⁃κB,TLR4 and u⁃mAlb levels in patients with urinary tract infection could be used for the early diagnosis of urinary tract infection.