脑瘤切除术后患儿感染病原菌分布及对血流动力学与sPD-L1表达影响研究  

Distribution of pathogens causing postoperative infections in children undergoing brain tumor resection and impact on hemodynamics and expression of sPD-L1

作　　者：王鹏[1] 王彦甲 吴绘[1] 刘爱彬[1] 张赛[1] 马铁柱[1] 

机构地区：[1]武警后勤学院附属医院脑科中心,天津300162

出　　处：《中华医院感染学杂志》2016年第18期4225-4227,共3页Chinese Journal of Nosocomiology

基　　金：天津市自然科学基金资助项目(12JCYBJC18500)

摘　　要：目的研究小儿脑瘤切除术后感染病原菌分布及对血流动力学与sPD-L1表达的影响,为临床治疗提供参考。方法选取2012年1月-2014年12月医院行脑瘤切除术的69例患儿进行调查研究,感染组:38例术后感染患儿,非感染组:31例术后未感染患儿,对照组:40例健康体检儿童;采用全自动微生物鉴定系统对感染病原菌株进行鉴定,并分析各组间血流动力学指标与sPD-L1表达的变化。结果脑瘤切除术后感染组患儿共检出病原菌38株,病原菌中革兰阳性菌13株,占34.21%,以金黄色葡萄球菌为主;革兰阴性菌25株占65.79%,以铜绿假单胞杆菌和肺炎克雷伯菌为主;感染组患儿CaO2与SjvO2水平明显高于非感染组和对照组,差异有统计学意义(P<0.05);感染组患儿外周血CRP与sPD-L1水平较非感染组和对照组显著升高,差异有统计学意义(P<0.05);Pearson相关性检验分析发现,感染组患者CD4和CD8与sPD-L1、CRP与sPD-L1均呈现负相关。结论脑瘤切除术后患儿容易发生感染,病原菌分布以革兰阳性菌和革兰阴性菌为主,术后感染导致脑供氧代谢平衡机制障碍和CRP与sPD-L1水平升高。OBJECTIVE To investigate the distribution of pathogens causing postoperative infections in children undergoing brain tumor resection and observe the impact on hemodynamics and expression of sPD-L1 so as to provide guidance for clinical treatment.METHODS A total of 69 children who underwent the brain tumor resection in the hospital from Jan 2012 to Dec 2014 were enrolled in the study;38children with postoperative infections were assigned as the infection group,and 31 patients without postoperative infections were assigned as the non-infection group;40healthy children who received the physical examination were set as the control group.The pathogens causing the infections were identified by using automatic microorganism identification system,and the hemodynamic parameters and change of expression of sPD-L1 were observed and compared among the three groups.RESULTS Totally 38 strains of pathogens were isolated from the children who had postoperative infections after the brain tumor resection,including 13（34.21%）strains of gram-positive bacteria and 25（65.79%）strains of gram-negative bacteria;the Staphylococcus aureus was the predominant species of the gram-positive bacteria;the Pseudomonas aeruginosa and Klebsiella pneumoniae were dominant among the gram-negative bacteria.The levels of CaO2 and SjvO2of the infection group were significantly higher than those of the non-infection group and the control group（P〈0.05）.As compared with the non-infection group and the control group,the levels of peripheral blood CRP and sPD-L1 were significantly elevated（P〈0.05）.The Pearson correlation test analysis revealed that the CD4 and CD8of the patients with infections were negatively correlated with sPD-L1,and the CRP was positively correlated with sPD-L1.CONCLUSIONThe children tend to have the infections after the brain tumor resection.The gram-positive bacteria and gram-negative bacteria are dominant among the pathogens.The postoperative infections may lead to the cerebral oxygen metabolic balance mechanism dis

关 键 词：患儿 脑瘤切除术 病原菌 血流动力学 

分 类 号：R378[医药卫生—病原生物学]