肺部肺炎克雷伯菌感染患者血清SOCS-1、sTREM-2、ACLY变化及临床意义

doi:10.11958/20241790

摘要/Abstract

摘要：

目的探究肺部肺炎克雷伯菌感染患者血清细胞因子信号转导抑制因子-1（SOCS-1）、可溶性髓样细胞触发受体-2（sTREM-2）、ATP柠檬酸裂解酶（ACLY）变化及临床意义。方法选取肺部肺炎克雷伯菌感染患者100例为感染组，同期本院的健康体检者70例为对照组。根据肺炎严重指数（PSI）评分，将感染组分为重度组（PSI>90分，32例）与轻度组（PSI≤90分，68例）。收集研究对象年龄、性别、白细胞计数（WBC）、降钙素原（PCT）、C反应蛋白（CRP）等指标；采用酶联免疫吸附试验对感染组和对照组SOCS-1、sTREM-2、ACLY表达水平进行检测；采用Pearson法分析感染组患者血清SOCS-1、sTREM-2、ACLY水平与PSI评分的关系；多因素Logistic回归分析影响肺部肺炎克雷伯菌感染患者病情的因素；受试者工作特征（ROC）曲线分析血清SOCS-1、sTREM-2、ACLY水平对肺部肺炎克雷伯菌感染的诊断价值。结果感染组WBC、PCT、CRP、SOCS-1、sTREM-2、ACLY表达水平高于对照组（P<0.01）。感染组血清SOCS-1、sTREM-2、ACLY水平与PSI评分均呈正相关（r分别为0.419、0.373、0.391，P<0.05）。重度组血清SOCS-1、sTREM-2、ACLY表达水平高于轻度组（P<0.01）。血清SOCS-1、sTREM-2、ACLY升高是肺部肺炎克雷伯菌感染患者重症的危险因素（P<0.05）。血清SOCS-1、sTREM-2和ACLY单独及联合诊断重度肺部肺炎克雷伯菌感染的曲线下面积（AUC）分别为0.787、0.837、0.847和0.929，联合诊断效能最高。结论肺部肺炎克雷伯菌感染患者血清SOCS-1、sTREM-2、ACLY水平升高，其表达水平与患者病情有关，三者联合对重度肺部肺炎克雷伯菌感染检测优于单独检测。

关键词: 肺炎, 肺炎克雷伯菌, 细胞因子信号转导抑制因子1, ATP柠檬酸（pro-S）裂合酶, 可溶性髓样细胞触发受体-2

Abstract:

Objective To investigate changes and clinical significance of serum cytokine signaling inhibitor-1 (SOCS-1), soluble myeloid triggering receptor-2 (sTREM-2) and ATP citrate lyase (ACLY) in patients with pulmonary Klebsiella pneumoniae infection. Methods A total of 100 patients infected with Klebsiella pneumoniae were selected as the infection group, and 70 healthy subjects in our hospital were selected as the control group. According to the pneumonia severity index (PSI) score, patients of the infection group were divided into the severe group (PSI>90, 32 cases) and the mild group (PSI≤90, 68 cases). The expression levels of SOCS-1, sTREM-2 and ACLY in the infection group and the control group were detected by enzyme-linked immunosorbent assay. Pearson method was used to analyze the relationship between serum levels of SOCS-1, sTREM-2, ACLY and PSI scores in the infection group. Multivariate Logistic regression analysis was performed to analyze factors affecting the disease status of patients with pulmonary Klebsiella pneumoniae infection. The diagnostic value of serum levels of SOCS-1, sTREM-2 and ACLY in patients with Klebsiella pneumoniae infection was analyzed by receiver operating characteristic curve (ROC). Results The levels of white blood cell (WBC) count, procalcitonin (PCT), C-reactive protein (CRP), serum SOCS-1, sTREM-2 and ACLY were higher in the infection group than those in the control group (P<0.01). In infection group, serum levels of SOCS-1, sTREM-2 and ACLY were positively correlated with PSI scores (r=0.419, 0.373, 0.391, P<0.05). Serum levels of SOCS-1, sTREM-2 and ACLY were higher in the severe group than those in the mild group (P<0.01). The elevated serum SOCS-1, sTREM-2 and ACLY were risk factors for severe disease in patients with pulmonary Klebsiella pneumoniae infection (P<0.05). The areas under the curve (AUC) of SOCS-1, sTREM-2 and ACLY alone and in combination for the diagnosis of severe pulmonary Klebsiella pneumoniae infection were 0.787, 0.837, 0.847 and 0.929, respectively, and the combined diagnostic efficiency was the highest. Conclusion Serum SOCS-1, sTREM-2 and ACLY are elevated in patients with pulmonary Klebsiella pneumoniae infection, and their expression levels are related to the condition of patients with pulmonary Klebsiella pneumoniae infection. The combined detection of the three is better than testing alone for severe pulmonary Klebsiella pneumoniae infection.

Key words: pneumonia, Klebsiella pneumoniae, suppressor of cytokine signaling 1 protein, ATP citrate (pro-S)-lyase, triggering receptor expressed on myeloid cells 2

中图分类号:

R563.1

图/表 7

参考文献 20

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组别		n		年龄/岁		男性			BMI/（kg/m²）				吸烟
对照组		70		55.67±8.84		36（51.43）			23.51±1.15				23（32.86）
感染组		100		56.85±7.17		55（55.00）			23.74±1.29				29（29.00）
χ²或t				0.957		0.211			1.247				0.289
组别	饮酒				高血压			糖尿病		冠心病		WBC/×10⁹/L
对照组	32（45.71）				16（22.86）			5（7.14）		6（8.57）		5.03±1.17
感染组	50（50.00）				26（26.00）			9（9.00）		8（8.00）		6.26±1.51
χ²或t	0.303				0.219			0.188		0.018		5.762^＊＊
组别			RBC/×10¹²/L				PCT/（μg/L）				CRP/（mg/L）
对照组			4.21±0.59				7.45±1.56				7.84±1.26
感染组			4.34±0.45				9.02±1.79				13.85±2.75
t			1.692				5.934^＊＊				17.103^＊＊

组别		n		年龄/岁		男性			BMI/（kg/m²）				吸烟
对照组		70		55.67±8.84		36（51.43）			23.51±1.15				23（32.86）
感染组		100		56.85±7.17		55（55.00）			23.74±1.29				29（29.00）
χ²或t				0.957		0.211			1.247				0.289
组别	饮酒				高血压			糖尿病		冠心病		WBC/×10⁹/L
对照组	32（45.71）				16（22.86）			5（7.14）		6（8.57）		5.03±1.17
感染组	50（50.00）				26（26.00）			9（9.00）		8（8.00）		6.26±1.51
χ²或t	0.303				0.219			0.188		0.018		5.762^＊＊
组别			RBC/×10¹²/L				PCT/（μg/L）				CRP/（mg/L）
对照组			4.21±0.59				7.45±1.56				7.84±1.26
感染组			4.34±0.45				9.02±1.79				13.85±2.75
t			1.692				5.934^＊＊				17.103^＊＊

组别	n	SOCS-1/（ng/L）	sTREM-2/（ng/L）	ACLY/（μg/L）
对照组	70	396.41±51.57	16.41±4.57	14.35±3.57
感染组	100	467.83±70.72	23.36±4.71	19.01±4.91
t		7.210^＊＊	9.588^＊＊	6.281^＊＊

组别	n	SOCS-1/（ng/L）	sTREM-2/（ng/L）	ACLY/（μg/L）
对照组	70	396.41±51.57	16.41±4.57	14.35±3.57
感染组	100	467.83±70.72	23.36±4.71	19.01±4.91
t		7.210^＊＊	9.588^＊＊	6.281^＊＊

组别		n		年龄/岁		男性			BMI/（kg/m²）				吸烟
轻度组		68		56.63±7.16		39（57.35）			23.66±1.27				20（29.41）
重度组		32		57.32±7.28		16（50.00）			23.94±1.32				9（28.13）
χ²或t				0.441		0.475			1.012				0.017
组别	饮酒				高血压			糖尿病		冠心病		WBC/×10⁹/L
轻度组	31（45.59）				15（22.06）			6（8.82）		5（7.35）		6.10±1.48
重度组	19（59.38）				11（34.38）			3（9.38）		3（9.38）		6.63±1.51
χ²或t	1.654				1.716			0.081		0.002		1.656
组别			RBC/×10¹²/L				PCT/（μg/L）				CRP/（mg/L）
轻度组			4.30±0.44				8.81±1.78				13.54±2.71
重度组			4.43±0.46				9.47±1.73				14.51±2.75
t			1.454				1.741				1.680