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    CD4+NKG2D+T细胞联合hs-CRP在急性脑梗死肺部感染中的诊断价值

    Diagnostic value of CD4+NKG2D+ T cells combined with hs-CRP in pulmonary infection in patients with acute cerebral infarction

      摘要
    • 摘要: 目的 检测CD4+NKG2D+T细胞在急性脑梗死肺部感染患者外周血中的表达水平,并分析其与超敏C反应蛋白(hs-CRP)联合检测对急性脑梗死肺部感染的预测价值。方法 选取2019年6月—2020年12月于徐州医科大学附属医院确诊的50例急性脑梗死合并肺部感染患者作为研究对象,并以同期住院的50例未合并肺部感染的急性脑梗死患者作为对照组。比较2组患者的临床资料以及外周血CD4+NKG2D+T细胞的表达水平。采用单因素和多因素Logistic回归分析筛查急性脑梗死合并肺部感染的危险因素,结合受试者工作特征曲线(ROC曲线)评价CD4+NKG2D+T细胞百分比和hs-CRP单独检测以及联合应用的预测价值。结果 与无肺部感染组相比,肺部感染组美国国立卫生研究院卒中量表(NIHSS)评分更高且多合并吞咽困难,血清中IL-6及hs-CRP水平更高,外周血CD4+NKG2D+T细胞表达明显增加,差异有统计学意义(P＜0.05)。经单因素和多因素Logistic回归分析显示,CD4+NKG2D+T细胞百分率、hs-CRP水平升高是急性脑梗死合并肺部感染的危险因素。ROC曲线显示,CD4+NKG2D+T细胞百分率、hs-CRP单独作为肺部感染预测指标时,其曲线下面积AUC分别为0.941和0.814,二者联合应用时AUC为0.962。结论 CD4+NKG2D+T细胞百分率与外周血hs-CRP水平联合应用对急性脑梗死并发肺部感染具有良好的诊断价值,可作为急性脑梗死发病早期预测并发肺部感染的生物学标志物。

       

      Abstract: Objective To explore the expression of CD4+NKG2D+T cells in peripheral blood of acute cerebral infarction patients with pulmonary infection, and to analyze the value of CD4+NKG2D+T cells combined with hypersensitive C-reactive protein (hs-CRP) in the diagnosis of pulmonary infection in patients with acute cerebral infarction. Methods A total of 50 acute cerebral infarction patients with pulmonary infection who were diagnosed the Affiliated Hospital of Xuzhou Medical University from June 2019 to December 2020 were selected as a study group.Meanwhile,50 acute cerebral infarction patients without pulmonary infection were selected as a control group.Both groups were compared for clinical data and the expression of CD4+NKG2D+T cells.Univariate and multivariate logistic regression analyses were used to screen the risk factors of pulmonary infection after acute cerebral infarction, and the receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of the percentage of CD4+NKG2D+T, hs-CRP and its combination in acute cerebral infarction patients with pulmonary infection. Results Compared with the non-pulmonary infection group, the pulmonary infection group presented increases in the National Institute of Health Stroke Scale(NIHSS) score and dysphagia, the levels of serum IL-6 and hs-CRP, and the levels of CD4+NKG2D+T cells in peripheral blood (P<0.05).According to univariate and multivariate logistic regression analyses, the increased percentage of CD4+NKG2D+T cells and hs-CRP were risk factors for pulmonary infection patients with acute cerebral infarction. The percentage of CD4+NKG2D+T cells and hs-CRP were used to predict their values in the diagnosis of pulmonary infection in patients with acute cerebral infarction.The area under the ROC curve (AUC) of CD4+NKG2D+T cells and hs-CRP were 0.941 and 0.814, while the AUC of CD4+NKG2D+T cells and hs-CRP increased to 0.962. Conclusions The percentage of CD4+NKG2D+T cells combined with hs-CRP has better diagnostic value for pulmonary infection in acute cerebral infarction and can be used as an early predictive marker of pulmonary infection in acute cerebral infarction.

       

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