摘要: |
目的 探讨中性粒细胞胞外网状陷阱(NETs)与多重耐药(MDR)菌感染对重症肺炎患者预后的影响。方法 选择171例重症肺炎患者,分为MDR组(n=86)和non-MDR组(n=85)。比较两组患者一般临床资料、实验室检查指标水平。采用Kaplan-Meier方法和Cox比例风险模型分析重症肺炎患者的生存率和预测因子。结果 与non-MDR组相比,MDR组NETs、SOFA评分、APACHE Ⅱ评分显著升高(P<0.01)。NETs与SOFA评分(r=0.202,P=0.008)、APACHEⅡ评分正相关(r=0.408,P=0.001)。MDR与non-MDR组患者28d生存率分别为58.48%、84.70%(P=0.0003)。单因素Cox回归分析显示,NETs影响重症肺炎患者预后(HR=1.0002,95%CI1.0001~1.0002,P=0.002);多因素Cox回归分析显示,分组是重症肺炎患者生存的独立影响因素(HR=0.288,95%CI0.151~0.548,P=0.0001)。结论 NETs在MDR菌引起的重症肺炎患者中升高,影响患者预后,但仍须进一步证明;MDR菌感染患者预后更差。 |
关键词: 中性粒细胞胞外网状陷阱 多重耐药菌 重症肺炎 预后 |
DOI:10.12025/j.issn.1008-6358.2022.20221556 |
分类号:R735.7 |
基金项目:复旦大学附属中山医院青年基金(2021ZSQN35). |
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Effect of neutrophil extracellular traps and multidrug resistant bacteria infection on prognosis of patients with severe pneumonia |
DING Hai-ling, WANG Jian-li, XU Fei-xiang
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Department of Emergency, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Abstract: |
Objective To explore the effect of neutrophil extracellular traps (NETs) on the multidrug resistance (MDR) bacteria-induced severe pneumonia. Methods A total of 171 severe pneumonia patients were enrolled and divided into MDR group (n=86) and non-MDR group (n=85). Clinical data and biochemical indices were compared between the two groups. Kaplan-Meier method and Cox proportional hazard model were used to analyze survival rate of patients and predictors. Results Compared with non-MDR group, the NETs level, SOFA score and APACHE Ⅱ score increased in the MDR group (P<0.01). NETs level was positively correlated with the SOFA score (r=0.202, P=0.008) and APACHE Ⅱ score (r=0.408, P=0.001). There was significant difference in survival rate between MDR and non-MDR groups (58.48% vs 84.70%, P=0.000 3). Univariate Cox regression analysis showed that NETs affected prognosis of patients with severe pneumonia (HR=1.000 2,95%CI 1.000 1-1.000 2, P=0.002). Multivariate Cox regression analysis showed that grouping was the independent prognostic factor for survival of patients (HR=0.288,95%CI 0.151-0.548, P=0.000 1). Conclusion NETs increase in patients with severe pneumonia induced by MDR bacteria, which may be a factor influencing the prognosis of these patients, and patients with MDR bacteria infection had worse prognosis. |
Key words: neutrophil extracellular traps multidrug-resistant bacteria severe pneumonia prognosis |