摘要
目的分析老年冠心病患者冠脉介入治疗术后感染现况及细胞色素P450家族成员2C19(CYP2C19)慢代谢型、高迁移率族蛋白(HMGB1)、甲壳质酶蛋白40(YKL-40)联合预测价值。方法将2020年3月-2023年3月锦州医科大学附属第一医院收治的205例冠脉介入治疗患者纳入研究,其中术后感染55例纳入感染组,无术后感染150例纳入非感染组,分析术后感染病原菌分布,比较两组患者CYP2C19慢代谢型占比及血清HMGB1、YKL-40水平,绘制受试者工作特征(ROC)曲线分析CYP2C19慢代谢型、HMGB1、YKL-40对术后感染的预测价值。结果205例老年冠心病冠脉介入治疗患者,术后感染55例,感染发生率为26.83%;共分离病原菌69株,其中革兰阴性菌占比71.01%;感染组CYP2C19慢代谢型占比、血清HMGB1、YKL-40水平高于非感染组(P<0.05);ROC曲线分析显示,CYP2C19慢代谢型、HMGB1、YKL-40联合对老年冠心病患者冠脉介入治疗术后感染的预测价值更高,曲线下面积(AUC)为0.924。结论老年冠心病患者冠脉介入治疗术后感染发生风险较高,病原菌以革兰阴性菌为主,CYP2C19慢代谢型、HMGB1、YKL-40水平与术后感染发生相关。
OBJECTIVE To investigate the prevalence of postoperative infection in the elderly coronary heart disease(CHD)patients undergoing coronary intervention therapy and analyze the predictive values of cytochrome P450 family member 2C19(CYP2C19)of slow metabolism type,high mobility group protein 1(HMGB1)and chitinase protein 40(YKL-1).METHODS A total of 205 patients who received coronary intervention therapy in the First Affiliated Hospital of Jinzhou Medical University from Mar 2020 to Mar 2023 were enrolled in the study,55 of whom had postoperative infection and were assigned as the infection group,and 150 who did not have postoperative infection and were assigned as the non-infection group.The distribution of pathogens causing the postoperative infection was analyzed,the proportion of patients with slow metabolism type of CYP2C19,serum HMGB1 and YKL-40 were compared between the two groups of patients,and the values of slow metabolism type of CYP2C19,HMGB1 and YKL-40 in prediction of the postoperative infection were analyzed by means of receiver operating characteristic(ROC)curve.RESULTS Among the 205 elderly patients with CHD who received coronary intervention therapy,55 had postoperative infection,with the incidence of infection 26.83%.Totally 69 strains of pathogens were isolated,71.01%of which were gram-negative bacteria.The percentage of slow metabolism type of CYP2C19,serum HMGB1 and YKL-40 levels were significantly higher in the infection group than in the non-infection group(P<0.05).ROC curve analysis showed that the value of the joint detection of slow metabolism type of CYP2C19,HMGB1 and YKL-40 was higher in prediction of the postoperative infection in the elderly CHD patients undergoing coronary intervention therapy,with the area under curve(AUC)0.924.CONCLUSION The elderly patients with CHD who receive coronary intervention therapy are at high risk of postoperative infection.The gram-negative bacteria are dominant among the pathogens.The slow metabolism type of CYP2C19,HMGB1 and YKL-40 are associated with the incidence of postoperative infection.
作者
刘思嘉
刘丹丹
高蔚然
崔雪曼
王新杨
LIU Si-jia;LIU Dan-dan;GAO Wei-ran;CUI Xue-man;WANG Xin-yang(First Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning 121000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第10期1502-1506,共5页
Chinese Journal of Nosocomiology
基金
辽宁省自然科学基金项目(2021-MS-325)。
