摘要
Abstract
Objective To explore the application effect of combined detection of serum soluble interleukin-2 receptor(sIL-2R)and matrix metalloproteinase-9(MMP-9)in the early diagnosis of pulmonary infection following cerebral infarction.Methods Fifty patients with cerebral infarction complicated with pulmonary infection admitted to Xinyang Central Hospital from January 2023 to April 2024 were retrospectively selected as pulmonary infection group.Another 53 cerebral infarction patients without infection were selected as the non-pulmonary infection group.General clinical data and serum levels of sIL-2R and MMP-9 were compared between the two groups.Multivariate logistic regression was applied to identify the independent risk factors for pulmonary infection in cerebral infarction patients.Receiver operating characteristic(ROC)curve analysis was employed to evaluate the diagnostic value of serum sIL-2R and MMP-9 levels for early diagnosis of cerebral infarction with pulmonary infection.The severity of pulmonary infection in the 50 infected patients was assessed using the Clinical Pulmonary Infection Score(CPIS),classifying them into severe infection(n=24)and mild/moderate infection(n=26)subgroups.Serum levels of sIL-2R and MMP-9 were compared between these severity subgroups.Spearman correlation analysis was used to assess the correlation between serum sIL-2R/MMP-9 levels and the severity of pulmonary infection in cerebral infarction.Results The proportions of smoking(54.00%vs.26.42%),hypertension(74.00%vs.47.17%),diabetes mellitus(60.00%vs.22.64%),disturbance of consciousness(66.00%vs.37.74%)and dysphagia(54.00%vs.15.09%)were significantly higher in the pulmonary infection group than in the non-pulmonary infection group(P<0.05).Serum levels of sIL-2R[(396.31±61.35)mg/L vs.(325.45±65.67)mg/L]and MMP-9[(88.18±9.15)ng/mL vs.(70.67±15.34)ng/mL]were also significantly higher in the pulmonary infection group(P<0.001).Multivariate logistic regression analysis identified dysphagia(OR=1.868,95%CI:1.160-3.008),NIHSS(National Institutes of Health Stroke Scale)score(OR=3.431,95%CI:1.497-7.862),sIL-2R(OR=2.404,95%CI:1.286-4.492)and MMP-9(OR=1.931,95%CI:1.209-3.085)as independent risk factors for pulmonary infection in cerebral infarction patients(P<0.05).ROC curve analysis revealed that the areas under the curve(AUC)for diagnosing pulmonary infection were 0.806 for serum sIL-2R,0.778 for MMP-9,and 0.860 for their combination,all indicating considerable diagnostic value.The levels of serum sIL-2R(426.51±65.97)mg/L and MMP-9(93.17±9.81)ng/mL in the severe infection group were significantly higher than in those with mild/moderate infection[(368.43±56.72)mg/L and(83.57±8.43)ng/mL,respectively;t=3.346 and 3.720,P<0.01].Spearman correlation analysis showed positive correlations between serum levels of sIL-2R(r=0.467)and MMP-9(r=0.431)and the severity of pulmonary infection(P<0.05).Conclusions Dysphagia,NIHSS score,sIL-2R and level of MMP-9 are identified as independent risk factors for pulmonary infection in patients with acute cerebral infarction.Both individual and combined detection of serum sIL-2R,MMP-9 have high diagnostic value on pulmonary infection in cerebral infarction.Furthermore,serum levels of sIL-2R and MMP-9 are positively correlated with infection severity,suggesting that combined detection may improve the diagnostic sensitivity.关键词
脑梗死/肺部感染/血清可溶性白介素-2受体/基质金属蛋白酶-9Key words
cerebral infarction/pulmonary infection/serum soluble interleukin-2 receptor/matrix metalloproteinase-9
