脊柱损伤患者术后切口感染病原学特征、红细胞免疫指标及降钙素原水平分析  

Analysis of pathogen characteristics,immune indicators,and procalcitonin levels in in patients with a postoperative surgical site infection after a spinal injury

作　　者：曾云 熊敏 何宁 王林 唐冰 ZENG Yun;XIONG Min;HE Ning;WANG Lin;TANG Bing(Orthopaedics,Dongfeng Hospital Affiliated with Hubei University of Medicine,Shiyan,Hubei,China 442008)

机构地区：[1]湖北医药学院附属东风医院骨科,湖北十堰442008

出　　处：《中国病原生物学杂志》2020年第5期580-582,共3页Journal of Pathogen Biology

基　　金：十堰市引导性科研项目(No.18Y88)。

摘　　要：目的研究脊柱损伤患者术后切口感染病原菌分布特征、红细胞免疫指标及降钙素原水平变化,并探讨其临床意义。方法选取在本院接受手术治疗的脊柱损伤患者200例,其中术后切口感染患者80例为观察组,术后切口未感染患者120例为对照组。利用全自动微生物鉴定系统对观察组患者送检标本进行菌株鉴定;检测两组患者免疫黏附促进因子(FEER)、红细胞-C3b受体(RBC-C3bR)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)及干扰素-γ(INF-γ)水平,并做协同肿瘤红细胞花环(ATER)和直向肿瘤红细胞花环(DTER)试验,进行比较分析。结果80例脊柱损伤术后感染患者送检标本共检出病原菌89株,其中革兰阴性菌63株(占70.79%),以大肠埃希菌(21株,23.59%)及铜绿假单胞杆菌(20株,22.48%)为主;革兰阳性菌26株(占29.21%),以金黄色葡萄球菌(12株,13.48%)为主。观察组患者红细胞免疫指标FEER、ATER、DTER及RBC-C3bR均显著低于对照组患者(t值分别为9.093、12.842、20.293、19.849,均P<0.05);血清炎症因子PCT、TNF-α及INF-γ水平均显著高于对照组患者(t值分别为43.980、34.495、11.731,均P<0.05)。结论脊柱损伤患者术后切口感染致病菌以革兰阴性菌为主。术后切口感染可导致患者免疫功能降低、炎性损伤加重,因此应加强对上述指标的监测及干预。Objectives To study the distribution of pathogenic bacteria,erythrocyte immune indicators,and procalcitonin levels in patients with a postoperative surgical site infection after a spinal injury and to explore their clinical significance.Methods Subjects were 200 patients with spinal injuries.Eighty patients with a surgical site infection served as the observation group,and 120 patients without a surgical site infection served as the control group.The bacterial strains were identified by an automated microbial identification system.FEER and RBC-C3 bR and levels of PCT,TNF-α,and IFN-γwere measured.The associated tumor erythrocyte rosette rate(ATER)and direct tumor erythrocyte rosette rate(DTER)were determined.The changes in the above indicators in the two groups were compared and analyzed.Results A total of 89 strains of pathogenic bacteria were detected in 80 patients with an infection after surgery for spinal injury.Of the 89 strains,63(70.79%)were strains of Gram-negative bacteria,which were mainly Escherichia coli(21 strains,23.59%)and Pseudomonas aeruginosa(20 strains,22.48%).Of the total strains,26(29.21%)were strains of Grampositive bacteria,which were mainly Staphylococcus aureus(12 strains,13.48%).In the observation group,FEER was45.12±4.67%,ATER was 50.38±5.04%,DTER was 24.36±2.61%,and RBC-C3 bR was 12.51±1.27%.In the control group,FEER was 51.75±5.29%,ATER was 61.15±6.27%,DTER was 33.64±3.49%,and RBC-C3 bR was17.16±1.82%.The serum levels of PCT,TNF-α,and inf-γin the observation group were 45.12±4.67 ng/mL,50.38±5.04 ng/mL and 12.51±1.27 ng/L respectively.The serum levels of PCT,TNF-α,and inf-γin the control group were 2.16±0.23 ng/mL,1.76±0.19 ng/mL,and 78.46±7.96 ng/mL,respectively.FEER,ATER,DTER,and RBC-C3 bR were significantly lower in patients in the observation group than in the control group(t values:9.093,12.842,20.293,and 19.849,respectively,P<0.05).The levels of PCT,TNF-α,and INF-γin serum were significantlyhigher than those in the control group(t values:43.980,34.495,and 1

关 键 词：脊柱损伤 感染 病原菌 免疫功能 炎症因子 

分 类 号：R378[医药卫生—病原生物学]