开放性骨折患者术后感染病原菌分布及对血清MMPs,SDF-1,VEGF和TNF-α表达影响研究  

The pathogen distribution in open fracture operation patients and its effects on serum MMPs,SDF-1,VEGF and TNF-α

作　　者：王宇强[1] 贾永森 苏学涛[1] 赵永军[1] 李中海[1] 刘天盛[1] 

机构地区：[1]武警后勤学院附属医院骨科,天津300162 [2]华北理工大学,河北唐山063009

出　　处：《临床和实验医学杂志》2016年第22期2223-2226,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省高等学校科学技术研究项目(编号:QN2016013)

摘　　要：目的分析开放性骨折患者术后感染病原菌分布,并研究其对基质金属蛋白酶(MMPs),基质细胞衍生因子1(SDF1),血管内皮生长因子(VEGF)及肿瘤坏死因子α(TNF-α)蛋白水平的影响。方法对2011年4月至2015年6月诊治的80例开放性骨折术后感染患者进行研究,以开放性骨折术后未感染患者250例设为未感染组,以同期健康体检者200例为对照组。应用生物梅里埃公司全自动微生物鉴定仪(VITEK Compact2)分析病原菌类型,酶联免疫吸附测定法分析三组对象血清中MMPs、SDF1,VEGF及TNF-α水平变化。结果 80例开放性骨折术后感染患者共分离病原菌80株,其中革兰阴性菌40株,占50.0%,以肺炎克雷伯菌占17.5%为主,革兰阳性菌40株,占50.0%,以肺炎链球菌占13.8为主;与对照组和未感染组相比,感染组患者血清中MMP2、MMP3、MMP9和MMP13水平明显升高,VEGF及SDF-1和TNF-α水平也显著上升,且差异有统计学意义(P<0.01)。结论开放性骨折患者术后容易受到病原菌感染,且感染引起患者血清中MMPs、SDF1,VEGF及TNF-α蛋白水平的升高。Objective The present study aimed to investigate the pathogen distribution in open fracture operation patients and its effects on serum MMPs, SDF - 1,VEGF and TNF - α. Methods Eighty cases of open fracture operation patients were enrolled into this research. 250 patients open fractures without infected were selected as not infected group, with the same period of 200 physical examination were as the control group. The isolated pathogens were identified with VITEC Compact2. The serum factors were assayed by ELISA methods. Results 80 strains of pathogens were isolated from the patients, including 40 gram negative strains （50.0%） and 40 gram positive strains （50.0%）. The serum MMP2, MMP3, MMP9, SDF - 1, VEGF and TNF -α were increased greatly when compared with control group and non -infected group patients （ P 〈 0.01 ）. Conclusion Open fracture patients are sensitive to pathogen infection and the serum MMP2, MMP3, MMP9, SDF - 1, VEGF and TNF - α are increased greatly after infection.

关 键 词：开放性骨折 术后感染 病原菌 基质金属蛋白酶 表皮生长因子 肿瘤坏死因子α 

分 类 号：R687.3[医药卫生—骨科学]