急性感染性腹膜炎并发急性肺损伤外周血CXCR4和sTLT-1水平

Peripheral blood CXCR4 and sTLT-1 of acute infectious peritonitis patients complicated with acute lung injury

目的分析急性感染性腹膜炎外周血趋化因子受体4(CXCR4)和可溶性髓样细胞触发受体样转录因子-1(sTLT-1)水平与急性肺损伤(ALI)的关系。方法选取杭州市临安区第一人民医院2021年1月-2023年6月收治的128例急性感染性腹膜炎患者为研究对象,根据ALI情况分为ALI组40例和无ALI组88例。对比两组急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、血清CXCR4、sTLT-1水平差异,采用多因素Logistic回归分析急性感染性腹膜炎患者发生ALI的影响因素,采用受试者工作特征(ROC)曲线分析血清CXCR4、sTLT-1水平对急性感染性腹膜炎患者发生ALI的预测效能。结果ALI组患者外周血中CXCR4、sTLT-1水平及APACHEⅡ评分均较无ALI组高(P<0.05);多因素Logistic回归分析显示,血清CXCR4、sTLT-1水平及APACHEⅡ评分均是急性感染性腹膜炎患者发生ALI的影响因素(P<0.05);ROC曲线分析显示,外周血血清CXCR4、sTLT-1水平均对急性感染性腹膜炎患者ALI有预测效能,二指标联合检测的预测效能最高(P<0.05),其曲线下面积为(AUC)为0.909,敏感度为90.00%,特异度为73.86%。结论急性感染性腹膜炎患者外周血血清CXCR4、sTLT-1水平与ALI的发病明显相关,可作为预测指标。

OBJECTIVE To analyze the association of peripheral blood CXC chemokine receptor 4(CXCR4)and soluble triggering receptor expressed on myeloid cells-like transcription factor-1(sTREM-1)with acute lung injury(ALI)in the patients with acute infectious peritonitis.METHODS A total of 128 patients with acute infectious peritonitis who were treated in the First People′s Hospital of Hangzhou Lin′an District from Jan.2021 to Jun.2023 were recruited as the study objects and were divided into the ALI group with 40 cases and the no ALI group with 88 cases according to the status of ALI.The Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,serum CXCR4 level and sTREM-1 level were compared between the two groups.Multivariate logistic regression analysis was performed for the influencing factors for ALI in the patients with acute infectious peritonitis.The efficiencies of the serum CXCR4 and sTREM-1 in prediction of ALI in the patients with acute infectious peritonitis were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The levels of peripheral blood CXCR4,sTREM-1 and APACHEⅡscore of the ALI group were higher than those of the no ALI group(P<0.05).Multivariate logistic regression analysis showed that the serum CXCR4 level,sTREM-1 level and APACHEⅡscore were the influencing factors for ALI in the patients with acute infectious peritonitis(P<0.05).ROC curve analysis showed that the peripheral blood serum CXCR4 and sTREM-1 had efficiencies in prediction of ALI in the patients with acute infectious peritonitis,and the predictive efficiency of the joint detection of the two indexes was the highest(P<0.05),the area under curve(AUC)was 0.909,with the sensitivity 90.00%,the specificity 73.86%.CONCLUSION There is remarkable association between the levels of peripheral blood serum CXCR4,sTREM-1 and the occurrence of ALI in the patients with acute infectious peritonitis,and the two indexes can be used as predictive indexes.