An analysis of pathogenic bacterial distribution and its effect on the expression of apoptosis protein in patients of acute cerebral infarction complicated with pulmonary infection / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate pathogenic bacteria distribution and its effect on the expression of apoptosis protein in patients with acute cerebral infarction (ACI) complicated with pulmonary infection. Methods A retrospective analysis was conducted. From January 2014 to October 2017, the clinical data of 178 patients suffered from ACI hospitalized in Department of Neuromedical Center of Affiliated Hospital of the Chinese People's Armed Police Force Logistics Academy were collected, including 86 cases with ACI complicated with pulmonary infection selected as the observation group, and 92 cases with ACI without pulmonary infection assigned in the control group. The identification and classification of pathogenic bacteria were carried out by using the French BioMieux microorganism fully automatic identification instrument; the contents of serum interleukins (IL-8, IL-17), soluble intercellular adhesion molecule-1 (sICAM-1) and B type lymphocyte tumor-2 related X protein (Bax), B lymphocyte tumor-2 protein (Bcl-2) in two groups were detected by enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was used to observe the correlations between sICAM-1 and Bax, Bcl-2 protein expression. Results From the bacterial cultures of 86 patients with ACI complicated with pulmonary infection, 86 strains of pathogenic bacteria were isolated, including 41 strains of gram positive (G+) bacteria (47.67%), mainly Staphylococcus aureus (25.58%); 37 strains of gram negative (G-) bacteria (43.02%), mainly Acinetobacter baumannii (11.63%); 8 strains of fungi (9.30%). The serum levels of IL-8 (μg/L 0.72±0.15 vs. 0.68±0.09), IL-17 (μg/L 9.31±3.58 vs. 8.12±2.76), sICAM-1 (ng/L 421.36±39.74 vs. 385.13±28.59) and Bax (μg/L 4.52±0.47 vs. 3.86±0.34) in the observation group were significantly higher than those in the control group, while the level of Bcl-2 in the observation group was significantly lower than that in the control group (μg/L 0.84±0.26 vs. 1.13±0.31), all the differences were statistically significant (all P ＜ 0.05). In the observation group, sICAM-1 was significantly positively correlated with Bax protein (r = 0.401, P ＜ 0.001), while sICAM-1 was significantly negatively correlated with Bcl-2 (r = -0.447, P ＜ 0.001). Conclusion The pathogenic bacteria of ACI patients complicated with pulmonary infection is mainly G+bacteria, the infection can induce elevation of serum pro-inflammatory factors and sICAM-1 levels in the patients, and the mechanisms may be related to the up-regulation of Bax protein expression and down-regulation of Bcl-2 protein expression.