Correlation Between Serum Interleukin33 And Stroke-associated Pneumonia In Patients

Objective:To explore whether serum interleukin33(IL-33)is associated with stroke-associated pneumonia(SAP).Methods:We enrolled 140 patients with acute ischemic stroke(AIS)who were treated in the First Affiliated Hospital of Chongqing Medical University from March 2019 to October 2019 retrospectively.Patients were divided into SAP group(39)and Non-SAP group(101)according to whether they were complicated with pneumonia within 48 hours after admission.Baseline including gender,age and risk factors of cerebrovascular disease,and clinical data like National Institutes of Health Stroke Scale(NIHSS)score,IL-33 concentration,NIHSS score>14,and invasive operation(gastric tube,urinary tube,tracheotomy)were all collected and analyzed.Serum IL-33 concentration was detected by immunoenzyme-linked adsorption assay(ELISA)test.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were to indicate the value of IL-33 for the prediction of AIS with pneumonia.Univariate and multivariate logistic regression analyses were to determine the risk factors of pneumonia in AIS patients.Results:(1)There were no statistically significant differences in hypertension,diabetes,hyperlipidemia,coronary heart disease(CHD),smoking,male proportion and age between the two groups(all P>0.05).(2)In the pneumonia group,the rate of NIHSS score(29)14 and invasive operation was higher than that in the AIS group without pneumonia[53.8%(21/39):18.8%(19/101),χ~2=16.922;51.3%(20/39):6.9%(7/101),χ~2=35.554,all P<0.01];in addition,IL-33 concentration and NIHSS score were higher than that in the AIS group without pneumonia[92.1(72.4,144.5)ng/L:63.4(45.2,80.9)ng/L,Z=-5.199;15.0(11.0,27.0):3.0(2.0,8.5),Z=-6.036,all P<0.01].(3)ROC curve analysis showed that IL-33 could predict the AIS with pneumonia with an area under the curve of 0.784(95%CI:0.697～0.871,P(27)0.01).When the cut-off value was74.4ng/L,its Youden index,sensitivity and specificity were 0.492,76.9% and 72.3%,respectively.(4)Multivariate Logistic regression analysis showed that IL-33 concentration≥74.4ng/L(OR=13.364,95%CI:4.275～41.722,P(27)0.01),NIHSS score(29)14(OR=4.420,95%CI:1.431～13.649,P=0.01),invasive operation(OR=12.158,95%CI:3.399～43.488,P(27)0.01)were risk factors for AIS in patients with pneumonia.Conclusion:Serum IL-33≥74.4ng/L is a risk factor for AIS complicated with pneumonia,but its diagnostic value remains to be further explored.