膀胱癌患者术后尿路感染免疫状态与炎症介质  

Immune state and inflammatory mediators of patients with urinary tract infections after bladder cancer operation

作　　者：操作亮[1] 刘双林[1] 袁劲东[1] 章传华[1] 黄遂斌[1] 吴维[1] 刘懿鹏 CAO Zuo-liang;LIU Shuang-lin;YUAN Jin-dong;ZHANG Chuan-hua;HUANG Sui-bin;WU Wei;LIU Yi-peng(Wuhan No.1 Hospital, Wuhan, Hubei 430022, China)

机构地区：[1]武汉市第一医院泌尿外科,湖北武汉430022

出　　处：《中华医院感染学杂志》2018年第11期1697-1700,共4页Chinese Journal of Nosocomiology

基　　金：吴阶平医学基金会临床科研专项基金资助项目(320.6750.15210);武汉市卫生计生委医疗卫生科研基金资助项目(武卫[2011]99号)

摘　　要：目的研究膀胱癌患者术后尿路感染免疫状态与炎症介质的变化情况。方法选取医院2013年1月-2015年12月膀胱癌术后发生尿路感染患者42例为试验组,并以同时期未发生感染的膀胱癌手术患者42例为对照组,将两组患者的细胞免疫指标、红细胞免疫指标及血清炎症介质进行比较,同时比较试验组中不同尿路感染部位及尿路状态患者的细胞免疫、红细胞免疫及血清炎症介质指标。结果试验组患者CD_4^+、CD_3^+CD_4^+、CD_4^+/CD_8^+及自然肿瘤红细胞花环率(natural tumor erythrocyte rosette,NTER)、协同肿瘤红细胞花环率(associated tumor erythrocyte rosette,ATER)、促肿瘤红细胞花环率(enhance tumor erythrocyte rosette,ETER)及直向肿瘤红细胞花环率(direct tumor erythrocyte rosette,DTER)分别为(35.28±3.25)%、(4.65±0.40)%、(1.26±0.10)及(1.32±0.20)%、(50.11±5.10)%、(33.23±4.61)%、(29.51±3.20)%,均低于对照组(P<0.001),CD_8^+及血清白细胞介素-1β(IL-1β)、IL-6、前列腺素E2(PGE2)、肿瘤坏死因子-α(TNF-α)分别为(27.98±3.23)%、(2.65±0.35)pg/ml、(7.67±0.68)pg/ml、(145.65±14.63)pg/ml及(1.25±0.17)ng/ml均高于对照组(P<0.001),而试验组中不同尿路感染部位及尿路状态者的细胞免疫、红细胞免疫及血清炎症介质指标差异有统计学意义(P<0.001)。结论膀胱癌术后尿路感染患者的免疫状态与炎症介质均处于相对较差的状态,且其表达水平受尿路感染部位及尿路状态的影响较大,因此应注意对此类患者进行术后尿路感染的防控及相关指标的监测。OBJECTIVE To investigate the immune state and inflammatory mediators of patients with urinary tract infections after bladder cancer operation.METHODS A total of 42 patients with urinary tract infections after bladder cancer operation in our hospital from Jan.2013 to Dec.2015 were selected as observation group,and 42 patients without urinary tract infections after bladder cancer operation at the same period were selected as control group.The cellular immune indexes,erythrocyte immune indexes and serum inflammatory mediators of the two groups were compared,and the cellular immune,erythrocyte immune and serum inflammatory mediators of observation group with different urinary tract infection sites and urinary tract state were compared.RESULTS The CD_4＋,CD_3＋CD_4＋,CD4/CD8 and NTER,ATER,ETER,DTER of observation group were（35.28±3.25）%,（4.65±0.40）%,（1.26±0.10）and（1.32±0.20）%,（50.11±5.10）%,（33.23±4.61）%,（29.51±3.20）%,respectively,which were all lower than those of control group（P〈0.001）.The CD_8＋and serum IL-1β,IL-6,PGE2,TNF-αof observation group were（27.98±3.23）%,（2.65±0.35）pg/ml,（7.67±0.68）pg/ml,（145.65±14.63）pg/ml and（1.25±0.17）ng/ml,which were all significantly higher than those of control group（P〈0.001）.The cellular immune,erythrocyte immune and serum inflammatory mediators of observation group with different urinary tract infection sites and urinary tract state all had significant differences too（P〈0.001）.CONCLUSIONThe immune state and inflammatory mediators of patients with urinary tract infection after bladder cancer operation all show worse state,and the influence of the urinary tract infection sites and urinary tract state for the expression levels are great,so the control and prevention of postoperative urinary tract infection and monitoring of related indexes should be paid more attention.

关 键 词：膀胱癌 术后尿路感染 免疫状态 炎症介质 

分 类 号：R619.3[医药卫生—外科学]