口腔颌面外科术后呼吸机相关性肺炎患者血清铁调素和铁蛋白临床分析

目的:研究口腔颌面外科术后呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)患者血清铁调素和铁蛋白的含量及临床意义.方法:选择2017年1月-2019年12月上海交通大学医学院附属第九人民医院收治的口腔颌面外科手术后行呼吸机治疗的患者196例,依据是否发生呼吸机相关肺炎分为VAP...

Clinical study of serum hepcidin and ferritin for ventilator-associated pneumonia after oral and maxillofacial surgery

PURPOSE: To investigate the changes and clinical significance of serum hepcidin and ferritin in patients with ventilator-associated pneumonia(VAP) after oral and maxillofacial surgery. METHODS: One hundred and ninety-six patients who underwent ventilator treatment after oral and maxillofacial surgery from January 2017 to December 2019 in Shanghai Ninth People's Hospital were selected. The patients were categorized into VAP group(n=100) and non-VAP group (n=96). VAP patients were divided into low-risk, intermediate-risk and high-risk subgroup, according to Acute Physiology and Chronic HealthⅡ(APACHEⅡ) score. The level of serum procalcitonin (PCT), hepcidin and ferritin was detected. SPSS 23.0 software package was used for statistical analysis. RESULTS: The hospitalization time and mechanical ventilation time of VAP group were significantly higher than those of non-VAP group (P<0.05). The PCT level and APACHEⅡ score of VAP group were (2.13±0.95)ng/mL and (23.68±6.70) points, which were both significantly higher than those in non-VAP group: (0.87±0.46)ng/mL and (17.22±5.19) points(P<0.05). The serum level of ferritin, hepcidin and ratio of ferritin/hepcidin in VAP group was (217.79±62.38) ng/mL, (57.62±9.60) ng/mL and 3.79±0.93, which was significantly higher than those in non-VAP group:(181.55±54.02) ng/mL,(50.58±8.52) ng/mL and 3.11±0.86, respectively (P<0.05）. The serum level of ferritin, hepcidin and ratio of ferritin/hepcidin in VAP patients in the low-risk subgroup, intermediate-risk subgroup and high-risk subgroup gradually increased (P<0.05). Spearman correlation analysis found that the severity of VAP was positively correlated with serum PCT, hepcidin, ferritin, and ferritin/hepcidin ratio (r=0.772, 0.811, 0.873, 0.898; P<0.05). CONCLUSIONS: Serum hepcidin and ferritin were significantly elevated in VAP patients, which can be used to evaluate the severity of VAP patients.