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青海大学附属医院呼吸与危重症科,西宁 810000
崔云翔,Email:sjnegz3288124@163.com,研究方向:支气管哮喘、肺部感染。
收稿:2025-06-11,
修回:2025-08-25,
纸质出版:2026-06-28
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崔云翔,华毛,张晴晴.支气管哮喘合并肺部感染患者病原菌分布及血清sTREM-1、HBD-2水平的预测价值[J].重庆医科大学学报,2026,51(06):882-887.
Cui Yunxiang,Hua Mao,Zhang Qingqing.Pathogen distribution and predictive value of serum sTREM-1 and HBD-2 levels in patients with bronchial asthma complicated with pulmonary infection[J].Journal of Chongqing Medical University,2026,51(06):882-887.
崔云翔,华毛,张晴晴.支气管哮喘合并肺部感染患者病原菌分布及血清sTREM-1、HBD-2水平的预测价值[J].重庆医科大学学报,2026,51(06):882-887. DOI: 10.13406/j.cnki.cyxb.003970.
Cui Yunxiang,Hua Mao,Zhang Qingqing.Pathogen distribution and predictive value of serum sTREM-1 and HBD-2 levels in patients with bronchial asthma complicated with pulmonary infection[J].Journal of Chongqing Medical University,2026,51(06):882-887. DOI: 10.13406/j.cnki.cyxb.003970.
目的
2
观察支气管哮喘(bronchial asthma,BA)合并肺部感染患者病原菌分布,并进一步探究血清可溶性髓样细胞触发受体-1(soluble triggering receptor expressed on myeloid cell,sTREM-1)、人β防御素-2(human beta defensin-2,HBD-2)水平的预测价值。
方法
2
选取2023年4月至2025年4月青海大学附属医院收治的162例BA患者作为观察对象,采集患者痰液标本进行病原菌培养,统计肺部感染发生率;根据是否合并肺部感染分为感染组、非感染组,比较2组一般资料、血清sTREM-1、HBD-2水平,分析BA合并肺部感染的影响因素及预测效能。
结果
2
162例BA患者中35.19%患者发生肺部感染,共分离出98株病原菌,其中62株革兰阴性菌、33株革兰阳性菌、3株真菌;感染组急性生理与慢性健康状况Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、长期使用糖皮质激素患者占比、C反应蛋白(C-reactive protein,CRP)、机械通气患者占比、sTREM-1、降钙素原(procalcitonin,PCT)、HBD-2均高于非感染组(
P
<
0.05);APACHEⅡ评分、机械通气、CRP、sTREM-1、HBD-2是BA合并肺部感染的影响因素(
P
<
0.05);APACHEⅡ评分、机械通气、CRP作为传统预测指标,血清sTREM-1、HBD-2水平作为新型预测指标,新型预测指标+传统预测指标联合预测BA合并肺部感染的曲线下面积为0.937,联合价值较高;决策曲线、校准曲线结果显示,新型预测指标+传统预测指标联合预测具有良好适用性和区分度。
结论
2
BA合并肺部感染病原菌以革兰阴性菌为主,且sTREM-1、HBD-2对预测BA患者合并肺部感染具有一定价值。
Objective
2
To observe the distribution of pathogenic bacteria in patients with bronchial asthma(BA) complicated with pulmonary infection, and to further explore the predictive value of serum soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) and human beta defensin-2(HBD-2) levels.
Methods
2
A total of 162 patients with BA admitted to the Affiliated Hospital of Qinghai University from April 2023 to April 2025 were enrolled as research subjects. Sputum specimens were collected for pathogenic bacterial culture, and the incidence of pulmonary infection was summarized. All patients were divided into infection group and non-infection group according to the complication of pulmonary infection. The general data and serum levels of sTREM-1 and HBD-2 were compared between the two groups. The influencing factors and predictive efficiency for BA complicated with pulmonary infection were analyzed.
Results
2
Among the 162 patients with BA,35.19% developed pulmonary infections,with a total of 98 strains of pathogenic bacteria isolated,including 62 strains of Gram-negative bacteria,33 strains of Gram-positive bacteria,and 3 strains of fungi. The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ) score,the proportion of patients with long-term glucocorticoid use,the proportion of patients requiring mechanical ventilation,C-reactive protein(CRP) level,sTREM-1 level,procalcitonin level,and HBD-2 level were all significantly higher in the infection group than in the non-infection group(
P
<
0.05). APACHEⅡ score,mechanical ventilation,CRP,sTREM-1,and HBD-2 were influencing factors for BA complicated with pulmonary infection(
P
<
0.05). Using the traditional indicators(APACHEⅡ score,mechanical ventilation,and CRP) combined with the novel indicators(serum sTREM-1 and HBD-2 levels) to predict the coexistence of BA and pulmonary infection,the area under the curve was 0.937,demonstrating excellent performance. The clinical decision curve and calibration curve showed that the combined prediction of novel predictive indicators and traditional predictive indicators presented good applicability and discrimination.
Conclusion
2
Gram-negative bacteria are the predominant pathogens in patients with BA complicated by pulmonary infection. Serum sTREM-1 and HBD-2 have certain predictive values for pulmonary infection in BA patients.
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