胸腰椎后路内固定术后早期手术部位感染患者的促炎因子和抗炎因子水平变化研究  

Change of proinflammatory cytokines and anti-inflammatory cytokines levels of patients with postoperative early surgical site infection undergoing posterior thoracic and lumbar internal fixation

作　　者：曹喜华[1] 王帅[2] 李海中[1] 徐国亭[1] 邓佩林[3] 袁海胜[4] 张洁靖[4] 

机构地区：[1]南阳医学高等专科学校第一附属医院麻醉科手术部,河南南阳473058 [2]南阳医学高等专科学校影像实验室,河南南阳473058 [3]南阳医学高等专科学校第一附属医院护理部,河南南阳473058 [4]南阳医学高等专科学校第一附属医院骨科,河南南阳473058

出　　处：《中华医院感染学杂志》2017年第1期151-153,共3页Chinese Journal of Nosocomiology

基　　金：河南省教育厅科学技术研究重点项目(141302111239)

摘　　要：目的探讨胸腰椎后路内固定术后早期手术部位感染对患者促炎因子和抗炎因子水平的影响,为手术部位感染预防和相关研究提供临床借鉴和参考。方法选取医院2013年1月-2014年12月临床收治的胸腰椎后路内固定术患者154例,根据早期手术部位感染情况将患者分为感染组和非感染组,各77例;针对两组患者的IgA、IgE、IgGl、IgG2、IgG等各项免疫指标和IL-1、IL-6、IL-8、TNF-α等各项血清促炎因子以及IL-4、IL-10、IL-13、TGF-β等各项血清抗炎因子进行观察和比较。结果感染组IgA、IgE、IgGl、IgG2、IgG低于非感染组;感染组IL-1、IL-6、IL-8、TNF-α高于非感染组;感染组IL-4、IL-10、IL-13、TGF-β高于非感染组,差异均有统计学意义(P<0.05)。结论胸腰椎后路内固定术后早期手术部位感染可导致患者免疫指标降低、促炎因子和抗炎因子水平显著升高,针对上述指标的检测对于感染的监控具有重要的意义。OBJECTIVE To explore the influence of postoperative early surgical site infection on proinflammatory cytokines and anti-inflammatory cytokines levels of patients undergoing posterior thoracic and lumbar internal fixa- tion so as to provide guidance for prevention of the surgical site infection. METHODS A total of 154 patients who received the posterior thoracic and lumbar internal fixation in hospitals from Jan 2013 to Dec 2014 were enrolled in the study and divided into the infection group and the non-infection group according to the status of early surgical site infection, with 77 cases in each group. The immune indexes such as IgA, IgE, IgG1, IgG2, and IgG, the ser- um proinflammatory cytokines such as IL-1, IL-6, IL-8, and TNF-α, and the serum anti-inflammatory cytokines such as IL-4, IL-10, IL-13, and TGF-β were observed and compared between the two groups of patients. RESULTS The levels of IgA, IgE, IgG1, IgG2, and IgG were lower in the infection group than in the non-infection group; the levels of IL-1, IL-6, IL-8, and TNF-α were higher in the infection group than in the non-infection group; the levels of IL-4, IL-10, IL-13, and TGF-β were higher in the infection group than in the non-infection group, and there was significant difference （P〈0.05）. CONCLUSION The postoperative early surgical site infec- tion in the patients undergoing the posterior thoracic and lumbar internal fixation may lead to the reduction of the immune indexes and the remarkable elevation of the proinflammatory cytokines and anti-inflammatory cytokines levels. The detection of the above indexes, has great significance to the monitoring of infection.

关 键 词：胸腰椎后路内固定术 手术部位感染 促炎因子 抗炎因子 

分 类 号：R619.3[医药卫生—外科学]