老年髋部骨折患者血清HSP70、ACTA、SACE对其术后肺部感染的预测价值OA

Objective:To explore the relationship between heat shock protein 70(HSP70),activin A(ACTA),and serum angiotensin converting enzyme(SACE)and postoperative pulmonary infection in elderly patients with hip fracture,as well as the predictive value of the three.Methods:From January 2022 to July 2025,105 elderly patients who underwent hip fracture surgery and were selected as the research subjects and divided into the infection group(21 cases)and the non-infection group(84 cases)based on the occurrence of postoperative pulmonary infection.The general information of the patients was collected,and the enzyme-linked immunosorbent assay(ELISA)kit was used to detect the levels of serum HSP70,ACTA and SACE.Multivariate Logistic regression model was used to analyze the factors associated with postop-erative pulmonary infection in elderly patients with hip fracture.Moreover,receiver operating characteristic(ROC)curve was used to evaluate the value of each index alone and their combination in the diagnosis of postoperative pulmona-ry infection.Relative risk analysis of the effects of different serum HSP70,ACTA,and SACE levels on postoperative pulmonary infection in elderly patients with hip fractures.Results:The incidence of pulmonary infection in this study was 20.00％(21/105).The infection group had greater age,the proportion of ASA grade≥grade Ⅲ,operation time,intraoperative blood loss,and intraoperative blood transfusion volume than the non-infection group(P＜0.05).The infection group had significantly higher levels of serum HSP70,ACTA and SACE than the non-infection group(P＜0.05).Advanced age,ASA classification≥grade Ⅲ,and high levels of serum HSP70,ACTA,and SACE are factors influencing postoperative pulmonary infection in the patients of this study.The area under the curve(AUC)of the combination of HSP70,ACTA and SACE in diagnosing postoperative pulmonary infection was 0.917,with a sensitivity of 90.48％and a specificity of 82.14％.The predictive efficacy was significantly superior to that of each index alone(P＜0.05).Patients with high levels of serum HSP70,ACTA,and SACE were 3.250,2.667,and 2.626 times more likely to develop postoperative pulmonary infection,respectively(P＜0.05).Conclusion:The levels of serum HSP70,ACTA and SACE are clearly increased in infected patients.The combined detec-tion of the three has a high predictive value for postoperative pulmonary infection,and can provide a reference for early clinical intervention.