糖尿病患者玻璃体切除术后感染病原菌分析与对血清膜联蛋白及热休克蛋白水平影响的研究  

Distribution of pathogens causing postoperative infections in diabetic mellitus patients undergoing vitrectomy and influence on levels of serum annexin protein and heat shock protein

作　　者：朱凯[1] 陈伟[1] 张莉[1] 王达良[1] 罗曼[1] 

机构地区：[1]绍兴市人民医院浙江大学绍兴医院眼科,浙江绍兴312300

出　　处：《中华医院感染学杂志》2016年第9期1979-1981,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生优秀青年科技人才专项科研基金资助项目(2009QN024)

摘　　要：目的研究医院糖尿病视网膜玻璃体切除术后患者感染病原菌分布及对患者血清膜联蛋白和热休克蛋白水平影响,为临床诊断和治疗提供参考。方法选取医院2011年1月-2015年7月收治的190例糖尿病视网膜玻璃体切除术感染患者,设为感染组,以医院同期健康体检者190名为对照组,糖尿病视网膜病玻璃体切除术后未感染病原菌患者190例为未感染组;对感染患者感染病原菌分布进行分析,对比3组患者血清中膜联蛋白、热休克蛋白及黏蛋白、碱性成纤维细胞生长因子和炎症因子水平的变化。结果 190例感染患者中皮肤感染61例、上呼吸道感染49例、肺部感染20例、肝胆系感染25例、尿道感染18例、血流感染17例,分离病原菌190株,其中革兰阳性菌92株占48.4%;革兰阴性菌98株占51.6%;感染患者血清中膜联蛋白、热休克蛋白及黏蛋白水平明显低于对照组和未感染组患者,而碱性成纤维细胞生长因子、白细胞介素-10和肿瘤坏死因子-α水平明显高于对照组和未感染组患者,且差异有统计学意义(P<0.05)。结论糖尿病视网膜玻璃体切除术后患者容易受到病原菌感染,且感染后患者血清中膜联蛋白和热休克蛋白存在明显异常。OBJECTIVE To investigate the distribution of pathogens causing postoperative infections in the diabetic mellitus patients undergoing vitreoretinal surgery and observe the influence on levels of serum annexin protein and heat shock protein so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 190 diabetic mellitus patients who underwent the vitreoretinal surgery from Jan 2011 to Jul 2015 and were complicated with postoperative infections were enrolled in the study and assigned as the infection group,meanwhile,190 healthy people who received the physical examination were chosen as the control group,and 190 diabetic mellitus patients who underwent the vitreoretinal surgery but were not complicated with postoperative infections were set as the non-infection group.The distribution of the pathogens causing the postoperative infections was analyzed,and the levels of serum annexin protein,heat shock protein,and mucoprotein and the levels of basic fibroblast growth factor and inflammatory factor were observed and compared among the three groups of patients.RESULTS Of the 190 patients with infections,61 had skin infections,49 had upper respiratory tract infections,20 had pulmonary infections,25 had hepatobiliary infections,18 had urinary tract infections,and 18 had bloodstream infections.Totally190 strains of pathogens were isolated,including 92（48.4%）strains of gram-positive bacteria and 98（51.6%）strains of gram-negative bacteria.The levels of serum annexin protein,heat shock protein,and mucoprotein of the patients with infections were significantly lower than those of the patients in the control group and the patients without infections;however,the levels of basic fibroblast growth factor,interleukin-10,and tumor necrosis factor-αof the patients with infections were significantly higher than those of the patients in the control group and the patients without infections（P〈0.05）.CONCLUSION The patients with diabetic mellitus tend to be infected with pathogens after the vitreoretin

关 键 词：糖尿病 视网膜病 玻璃体切除 感染 热休克蛋白 膜联蛋白 

分 类 号：R587.1[医药卫生—内分泌]