血清前白蛋白、可溶性白介素-2受体、淀粉样蛋白A水平与老年脑卒中并发肺部感染的相关性

目的 探究血清前白蛋白(PA)、可溶性白介素-2受体(SIL-2R)、淀粉样蛋白A(SAA)水平与老年脑卒中并发肺部感染的相关性.方法 选取2017年5月至2020年4月新乡医学院第一附属医院老年脑卒中病人272例,根据有无并发肺部感染分为感染组41例与未感染组231例.分析老年脑卒中病人并发肺部感染相关危险因素,对比...

Correlation between serum PA,sIL-2R,SAA levels and pulmonary infection in elderly patients with stroke

Objective To explore the relationship between serum prealbumin (PA), soluble interleukin-2 receptor (sIL-2R), amyloid A (SAA) levels and pulmonary infection in elderly patients with stroke.Methods Two hundred and seventy-two elderly patients with stroke in the First Affiliated Hospital of Xinxiang Medical College from May 2017 to April 2020 were selected as the research objects,according to the presence or absence of concurrent pulmonary infections, they were assigned into infected group (n=41) and uninfected group (n=231). The risk factors related to pulmonary infection in elderly stroke patients were analyzed, and the serum levels of PA, sIL-2R and SAA were compared between the two groups. The ROC curve was used to analyze the diagnostic value of pulmonary infection in elderly stroke patients. The serum levels of the three indicators in patients with different infection levels were compared, and the corre?lation analysis between the three serum indicators was performed.Results The logistic model showed that history of chronic obstruc?tive pulmonary disease (COPD), history of hypertension, history of diabetes, disturbance of consciousness, difficulty swallowing, pro?longed bed rest, invasive procedures, and use of antibacterial drugs were all risk factors for lung infection in elderly stroke (P<0.05).The serum PA level of the infected group was lower than that of the uninfected group [(159.67±46.83) mg/L vs. (235.67±51.32)mg/L],and the levels of SIL-2R [(427.85±41.23) mg/L vs. (342.72±39.64) mg/L] and SAA [(52.37±10.89) mg/L vs. (35.42±8.41) mg/L] were higher than that of the uninfected group (P<0.05). The ROC curve showed that SAA had the highest AUC and Youden index (0.787,0.558), SAA and sIL-2R had the highest sensitivity (80.49%), and PA had the highest specificity (80.09%).The AUC of SAA diagnosis was significantly higher than that of sIL-2R (0.787 vs. 0.738, P<0.05), and the AUC of PA, sIL-2R and SAA combined diagnosis was significantly higher than that of each indicator alone (0.864 vs. 0.751, 0.728, 0.787, P<0.05). The serum PA level of general infection patients in elderly stroke with pulmonary infection was higher than that of severe infection patients, and the levels of sIL-2R and SAA were lower than those of severe infection patients (P<0.05). Serum PA was negatively correlated with sIL-2R and SAA in elderly pa?tients with stroke and pulmonary infection (P<0.05), and sIL-2R was positively correlated with SAA (P<0.05).Conclusions The sIL-2R and SAA in elderly patients with stroke complicated with pulmonary infection increase, and the PA level decreases, which is related to the degree of infection. The combined detection of serum sIL-2R, SAA and PA levels can help improve the sensitivity and specificity,and provide a reference for early clinical diagnosis and treatment of elderly stroke complicated with pulmonary infection.