TNF-α、IFN-γ及eGFR在老年肺结核患者中的表达意义及合并肺部感染患者的病原菌分布特点  

Expression of TNF-α,IFN-γ and e GFR in Elderly Patients with Pulmonary Tuberculosis and Distribution Characteristics of Pathogenic Bacteria in Patients with Complicated with Pulmonary Infection

作　　者：涂军[1] TU Jun(The Second People＇s Hospital of Jingzhou,Jingzhou 434000,China)

机构地区：[1]湖北省荆州市第二人民医院,湖北荆州434000

出　　处：《中国医学创新》2018年第23期99-103,共5页Medical Innovation of China

摘　　要：目的:探讨肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)及肾小球滤过率功能(e GFR)在老年肺结核患者中的表达及合并肺部感染患者的病原菌分布特点。方法:选取2015年1月-2017年12月本院诊治的97例老年肺结核患者作为研究对象,根据患者病情进展程度将其分为病灶超过2个肺野或有空洞形成组(n=36)和病灶未超过2个肺野组(n=61)。入院后抽取空腹血化验血常规,检测TNF-α以及IFN-γ表达水平,同时检测e GFR阳性表达率,并对住院后出现肺部感染的患者进行病原菌检测,分析其分布特点。结果:病灶超过2个肺野或有空洞形成组患者的TNF-α以及IFN-γ表达水平均明显高于病灶未超过2个肺野组,差异均有统计学意义(t=4.277 1、2.789 3,P=0.000 1、0.009 7);两组EGFR阳性表达率比较,差异无统计学意义(t=0.752 1,P=0.651 2)。97例老年患者检测结果显示,阳性标本42例,共分离出致病菌株43株。其中革兰阴性菌检出率最高,共24株,构成比55.81%,其中以铜绿假单胞菌和鲍氏不动杆菌检出株数最高;革兰阳性菌检出18株,构成比41.86%,其中以金黄色葡萄球菌检出率最高。结论:TNF-α、IFN-γ均可作为评价治疗是否成功的参数,病原菌特点以革兰阴性菌感染率最高。Objective：To explore the expression of TNF-α,IFN-γ and e GFR in elderly patients with pulmonary tuberculosis and distribution characteristics of pathogenic bacteria in patients with complicated with pulmonary infection.Method：A total of 97 elderly patients with pulmonary tuberculosis treated in our hospital from January 2015 to December 2017 were selected as the study objects.According to the degree of disease progression,they were divided into two groups：the lesions were more than 2 lung fields or the cavity formation group（n=36） and the lesions were not more than 2 lung fields groups（n=61）.After admission,fasting blood samples were collected to detect the expression of TNF-α and IFN-γ,and the positive expression rate of e GFR was detected. The pathogenic bacteria in the patients with pulmonary infection were detected and their distribution characteristics were analyzed.Result：The expression levels of TNF-α and IFN-γ in patients with more than 2 lung fields or cavities formation group were significantly higher than those in not more than 2 lung fields group,the differences were statistically significant（t=4.277 1,2.789 3;P=0.000 1,0.009 7）.There was no significant difference in the positive expression rate of e GFR between the two groups（t=0.752 1,P=0.651 2）.The results of 97 elderly patients showed that 43 strains of pathogenic bacteria were isolated from 42 positive specimens.The detection rate of gram-negative bacteria was the highest,24 strains were detected,composition ratio was 55.81%.Among them, pseudomonas aeruginosa and acinetobacter baumannii were the most detected. 18 strains of gram-positive bacteria were detected,and the composition ratio was 41.86%.The detection rate of Staphylococcus aureus was the highest.Conclusion：The TNF-α and IFN-γ can be used as a parameter to evaluate the success of the treatment,which the infection rate of Gram-negative bacteria are the highest in the pathogenic bacteria.

关 键 词：肿瘤坏死因子-α 结核分枝杆菌 干扰素-Γ 病原菌特点 

分 类 号：R521[医药卫生—内科学] R563.1[医药卫生—临床医学]