重症颅脑外伤患者肺部感染的氧化应激与TF和TFPI-1  

Oxidative stress,TF and TFPI-1 of pulmonary infection in patients with severe craniocerebral trauma

作　　者：王新玲[1] 李燕敏[2] 侯素君 WANG Xin-ling;LI Yan-min;HOU Su-jun(Hospital of Traditional Chinese Medicine of Rizhao,Rizhao,Shandong 276800,China)

机构地区：[1]山东省日照市中医医院感染管理办公室,山东日照276800 [2]山东省日照市中医医院神经外科,山东日照276800 [3]山东省日照市中医医院检验科,山东日照276800

出　　处：《中华医院感染学杂志》2020年第4期564-567,共4页Chinese Journal of Nosocomiology

基　　金：山东省科学技术研究发展计划基金资助项目(2015D04-16)。

摘　　要：目的探讨肺部感染对重症颅脑外伤患者氧化应激、组织因子(Tissue Factor,TF)、组织因子途径抑制物-1(Tissue factor pathway inhibitor-1,TFPI-1)的影响。方法选取2016年9月-2019年2月于山东省日照市中医医院住院治疗的156例重症颅脑外伤患者为研究对象,其中合并肺部感染的患者共计35例并设为感染组,未发生肺部感染的121例患者设为对照组。统计感染组患者病原学结果;测定并比较两组患者氧化应激(丙二醛(Malondialdehyde,MDA)、超氧化物歧化酶(Superoxide dismutase,SOD)以及过氧化氢酯(Catalase,CAT))、TF、TFPI-1、炎症因子指标水平变化。结果重症颅脑外伤伴肺部感染患者共检出病原菌41株,其中革兰阴性菌占65.85%(27/41),革兰阳性菌占26.83%(11/41),真菌占7.32%(3/41)。感染组患者MDA为(19.11±3.09)U/ml高于对照组,SOD和CAT为(17.68±2.89)U/L、(21.55±1.89)U/ml低于对照组(P<0.001)。感染组患者TF、TFPI-1分别为(47.09±9.08)ng/L、(40.95±8.16)μg/L高于对照组(P<0.001)。感染组患者IL-4、IL-6分别为(86.46.09±10.81)ng/L、(15.35±1.52)pg/ml高于对照组(P<0.001)。结论重症颅脑外伤肺部感染患者中的主要致病菌为革兰阴性菌,且肺部感染导致机体氧化应激状态紊乱,并能够对TF、TFPI-1水平变化造成不同程度的影响,而明确术后感染原因有利于患者预后效果的进一步提高。OBJECTIVE To investigate the effects of pulmonary infection on oxidative stress,TF and TFPI-1 in patients with severe craniocerebral trauma.METHODS A total of 156 patients with severe craniocerebral injury hospitalized in Rizhao Hospital of traditional Chinese medicine from Sep.2016 to Feb.2019 were selected as the study subjects.Among them,a total of 35 patients with pulmonary infection were assigned to infection group and 121 patients without pulmonary infection were assigned to control group.The pathogenic results of patients in the infection group were evaluated,and the changes of MDA,SOD,cat,TF,TFPI-1 and inflammatory factors were measured and compared between the two groups.RESULTS A total of 41 strains of pathogenic bacteria were detected in patients with severe craniocerebral trauma and pulmonary infection,among which Gram-negative bacteria accounted for 65.85%(27/41),Gram-positive bacteria accounted for 26.83%(11/41),and fungi accounted for 7.32%(3/41).The levels of MDA of the infected group was(19.11±3.09)U/ml,significantly higher than that of the control group,SOD and CAT of the infected group was(17.68±2.89)U/L and(21.55±1.89)U/ml,respectively,significantly lower than those in the control group(P<0.01).The levels of TF and TFPI-1 in the infected group was(47.09±9.08)ng/L and(40.95±8.16)μg/L,respectively,significantly higher than those in the control group(P<0.001).The levels of IL-4 and IL-6 was(86.46.09±10.81)ng/L and(15.35±1.52)pg/ml,respectively,in the infected group,significantly higher than those in the control group(P<0.001).CONCLUSION Gram-negative bacteria were the main pathogens in patients with severe craniocerebral trauma complicated with pulmonary infection,and pulmonary infection caused disorders of oxidative stress in the body,which had a profound impact on the changes of TF and TFPI-1 levels.Defining the cause of postoperative infection is helpful to further improve the prognosis of patients.

关 键 词：颅脑外伤 肺部感染 组织因子 氧化应激 

分 类 号：R563.1[医药卫生—呼吸系统]