骨科术后感染患者的IL-6与IL-8及T淋巴细胞亚群变化研究  

Changes of IL-6,IL-8 and T lymphocyte subsets in infected patients after orthopedic surgery

作　　者：刘艳明[1] 吴小松[1] 陈小刚 刘元富 何肖丞[1] LIU Yan-ming WU Xiao-song CHEN Xiao-gang LIU Yuan fu HE Xiao-cheng(Jingmen First People＇s Hospital, Jingmen, Hubei 448000, Chin)

机构地区：[1]湖北省荆门市第一人民医院骨科,湖北荆门448000

出　　处：《中华医院感染学杂志》2017年第20期4732-4735,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨骨科患者在手术后发生感染情况及检测白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和T淋巴细胞亚群水平变化的临床研究,为骨科术后感染的临床防治和治疗提供参考依据。方法选取2014年12月-2016年10月期间医院进行骨科手术的患者65例为研究对象,对患者的术后感染发生情况进行统计,术后发生感染患者21例作为感染组,术后未发生感染患者44例设为对照组,并将感染患者的致病菌进行培养鉴定,同时观察患者的IL-6、IL-8及T淋巴细胞亚群的变化。结果研究中的65例骨科术后患者有21例发生感染,感染率为32.31%;感染患者共计检测病原菌84株,其中革兰阴性菌51株占60.71%,革兰阳性菌29株占34.52%,真菌4株占4.76%;感染患者的IL-6(42.16±3.52)ng/L、IL-8(54.15±7.91)ng/L明显高于非感染患者的IL-6(14.81±7.35)ng/L、IL-8(42.18±10.17)ng/L水平;感染患者的CD_3^+(58.29±6.04)%、CD_4^+(43.94±2.75)%、CD_4^+/CD_8^+(0.64±0.03)明显高于非感染患者的CD_3^+(49.01±5.72)%、CD_4^+(22.59±3.27)%、CD_4^+/CD_8^+(1.08±0.31)。结论骨科患者在术后发生感染的情况较为严重,其中革兰阴性菌感染居多,感染患者的IL-6、IL-8与T淋巴细胞亚群水平较非感染患者明显升高,提示可作为临床判断术后感染的重要指标。OBJECTIVE To explore the infections of patients after orthopedic surgery and detect the changes of the levels of interleukin-6（IL-6）,interleukin-8（IL-8） and T lymphocyte subsets,so as to provide references for clinical control and treatment of postoperative infections of orthopedic.METHODS A total of 65 patients who underwent orthopedic surgery from Dec.2014 to Oct.2016 were selected as the study subjects.The incidence of postoperative infections was statistically analyzed.Totally 21 cases of postoperative infections were set as infection group,and 44 cases without infections after operation were set as control group.The pathogens of the infected patients were cultured and identified.The changes of IL-6,IL-8 and T lymphocyte subsets were observed.RESULTS Totally 21 cases were infected in the 65 cases of orthopedic surgery,and the infection rate was 32.31%.Totally 84 strains of pathogenic bacteria were detected,among them,51 strains were gram-negative bacteria,accounting for 60.71%,29 strains were gram-positive bacteria,accounting for 34.53%,and 4 strains were fungi,accounting for 4.76%.The levels of IL-6 and IL-8 of infection group were（42.16±3.52）ng/L and（54.15±7.91）ng/L,which were significantly higher than（14.81±7.35）ng/L and（42.18± 10.17）ng/L of non-infected group.The levels of CD_3^＋,CD_4^＋ and CD_4^＋/CD_8^＋ of infection group were（58.29±6.04）%,（43.94±2.75）%and（0.64 ± 0.03）%,which were significantly higher than（49.01 ± 5.72）%,（22.59±3.27）% and（1.08±0.31）% of non-infected patients.CONCLUSION Infection in orthopedic patients is serious,and the main pathogens were gram-negative bacteria.Among them,IL-6,IL-8 and T lymphocyte subsets are higher in infected patients than in non-infected ones.These indexes can be used as the important indicators of clinical postoperative infections.

关 键 词：骨科术后 感染 IL-6 IL-8 T淋巴细胞亚群 

分 类 号：R619.3[医药卫生—外科学]