天疱疮患者创面感染病原菌及血清IL-17和 IFN-γ与骨桥蛋白水平  

Pathogens isolated from pemphigus patients with wound infection and levels of serum IL-17, IFN-γ and osteopontin

作　　者：曾令斌 陆捷洁[1] 吴伟伟[1] 韩秋月 王爱民[1] ZENG Ling-bin;LU Jie-jie;WU Wei-wei;HAN Qiu-yue;WANG Ai-min(Hainan Provincial Dermatology Hospital(Hainan Provincial Center for Dermatology and Venereal Disease Control),Haikou,Hainan 570000,China)

机构地区：[1]海南省皮肤病医院(海南省皮肤性病防治中心),海南海口570000

出　　处：《中华医院感染学杂志》2020年第21期3336-3340,共5页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(818QN328)。

摘　　要：目的探讨天疱疮患者创面感染病原菌及血清白细胞介素-17(IL-17)、干扰素γ(IFN-γ)、骨桥蛋白(OPN)水平变化及其意义。方法选取2016年12月-2019年9月海南省皮肤病医院98例天疱疮并发创面感染患者为研究组,未并发创面感染的天疱疮患者324例为对照组。对比两组血清IL-17、IFN-γ、OPN水平及其与天疱疮并发创面感染相关性,并分析天疱疮并发创面感染病原菌、耐药性及血清IL-17、IFN-γ、OPN水平对病原菌类型的鉴别价值。结果研究组血清IL-17、IFN-γ、OPN水平高于对照组(P<0.05);血清IL-17、IFN-γ、OPN水平均与天疱疮并发创面感染具有显著相关性(P<0.05);细菌感染患者血清IL-17、IFN-γ、OPN水平均高于真菌感染患者(P<0.05);血清IL-17、IFN-γ、OPN联合对天疱疮并发创面感染病原菌类型的敏感度(93.75%)高于IL-17(62.50%)、IFN-γ(50.00%)、OPN(50.00%)。结论血清IL-17、IFN-γ、OPN水平在天疱疮患者创面感染中呈异常高表达,综合检测上述血清指标水平能有效鉴别与诊断感染病原菌类型,为临床分析病原菌耐药性、合理应用抗菌药物提供量化参考。OBJECTIVE To explore the distribution of pathogens isolated from the pemphigus patients with wound infection and observe the levels of serum interleukin-17(IL-17),interferon gamma(IFN-gamma)and osteopontin(OPN)as well as their significance.METHODS Totally 98 pemphigus patients complicated with wound infection who were treated in Hainan Provincial Dermatology Hospital from Dec 2016 to Sep 2019 were chosen as the study group,and 324 pemphigus patients without wound infection were set as the control group.The levels of serum IL-17,IFN-γand OPN were compared between the two groups,the correlation between the levels of the indexes and the wound infection was observed,the distribution and drug resistance of the pathogens causing wound infection were analyzed,and the value of the serum IL-17,IFN-γand OPN in identification of the pathogens was observed.RESULTS The levels of serum IL-17,IFN-γand OPN of the study group were significantly higher than those of the control group(P<0.05).The levels of serum IL-17,IFN-γand OPN were significantly associated with the wound infection in the pemphigus patients(P<0.05).The levels of serum IL-17,IFN-γand OPN of the patients with bacterial infection were significantly higher than those of the patients with fungal infection(P<0.05).The sensitivity of the joint detection of serum IL-17,IFN-γand OPN was 93.75%in identification of the pathogens causing wound infection in the pemphigus patients,higher than 62.50%of IL-17,50.00%of IFN-γ,50.00%of OPN.CONCLUSION The levels of serum IL-17,IFN-γand OPN of the pemphigus patients with wound infection are abnormally high,the joint detection of the above serum indexes can effectively identify the species of the pathogens causing the wound infections and provide guidance for clinical analysis of drug resistance and reasonable use of antibiotics.

关 键 词：天疱疮 创面感染 耐药性 白细胞介素-17 干扰素Γ 骨桥蛋白 

分 类 号：R751[医药卫生—皮肤病学与性病学]