骨科创伤感染患者血清NAP和SAA的表达与Th1/Th2平衡的关系研究  

Relationship between expression of serum NAP and SAA and Th1/Th2 balance in patients with orthopedic trauma infection

作　　者：赵兴东[1] 林牧[2] 邬夏荣[1] 张俊凯[1] 冷家雄 ZHAO Xing-dong;LIN Mu;WU Xia-rong(Department of Orthopedics,2 Central Laboratory,Guizhou Aerospace Hospital,Zunyi Guizhou 563000,China)

机构地区：[1]贵州航天医院骨科,贵州遵义563000 [2]贵州航天医院中心实验室,贵州遵义563000

出　　处：《临床和实验医学杂志》2021年第14期1507-1510,共4页Journal of Clinical and Experimental Medicine

基　　金：贵州省科技厅资助项目(编号:黔科合基础【2017】1213)。

摘　　要：目的探索骨科创伤感染患者血清中性粒细胞碱性磷酸酶(NAP)、血清淀粉样蛋白A(SAA)表达水平以及创伤感染与辅助性T细胞1、2(Th1、Th2)的相关关系。方法回顾性选取2016年6月至2021年1月间在贵州航天医院接受骨科手术治疗的患者100例作为研究对象,按照是否出现感染相关症状分为感染组32例和非感染组68例。所有患者分别于术前第3天、术后第5天抽取外周静脉血5 mL,检测NAP、SAA及Th1、Th2水平。对比2组患者NAP、SAA、Th1、Th2、Th1/Th2的差异。多因素Logistic回归分析骨创伤感染与Th1、Th1/Th2的相关性。结果术前,感染组的NAP积分、SAA值与非感染组相比,差异无统计学意义(P>0.05);术后,感染组的NAP积分、SAA值为(285.68±84.47)分、(81.05±10.28)IU/L,显著高于非感染组[(128.34±0.29)分、(44.02±7.54)IU/L],差异均有统计学意义(P<0.05)。术前,感染组Th1、Th2、Th1/Th2与非感染组相比,差异无统计学意义(P>0.05);术后,感染组的Th1/Th2平衡被打破,Th1、Th1/Th2为(22.28±4.15)%、5.83±0.85,显著低于非感染组[(29.65±6.08)%、14.98±3.04],Th2(4.08±0.73)%,显著高于非感染组[(2.69±0.64)%],差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,术后骨创伤感染与Th1和Th1/Th2的值存在明显相关关系。结论骨科创伤感染患者血清NAP、SAA的显著升高,血液Th1/Th2平衡被打破,感染患者Th1细胞百分比显著下降,而Th2有所上升,且Th1和Th1/Th2的变化与骨科创伤感染存在一定相关性,为探索新的骨科创伤感染的临床诊断方法提供依据。Objective To investigate the expression levels of neutrophil alkaline phosphatase(NAP)and serum amyloid A(SAA)in patients with orthopedic trauma infection and the correlation between traumatic infection and helper T cells 1,2(Th1,Th2).Methods A total of 100 patients who received orthopedic surgery in Guizhou Aerospace Hospital from June 2016 to January 2021 were selected as the research subjects.According to the occurrence of infection-related symptoms,they were divided into the infected group and the non-infected group,with 32 cases in the infected group and 68 cases in the non-infected group.Peripheral venous blood 5 mL was extracted from all patients on the 3rd day before surgery and the 5th day after surgery,and the levels of NAP,SAA,Th1 and Th2 were detected.The differences of NAP,SAA,Th1,Th2,Th1/Th2 between the two groups of patients were compared.The correlation between bone trauma infection and Th1,Th1/Th2 was analyzed by multivariate Logistic regression.Results Before operation,the NAP score and SAA value of the infected group were not statistically different from those of the non-infected group(P>0.05);after the operation,the NAP score and SAA value of the infected group were(285.68±84.47)points,(81.05±10.28)IU/L,which were significantly higher than those of the non-infected group[(128.34±0.29)points,(44.02±7.54)IU/L],and the differences were statistically significant(P<0.05).Before operation,the Th1,Th2,Th1/Th2 values of the infected group were not significantly different from those of the non-infected group(P>0.05);after the operation,the Th1/Th2 balance of the infected group was broken,the Th1 and Th1/Th2 ratios of the infected group were(22.28±4.15)%,5.83±0.85,which were significantly lower than those of the non-infected group[(29.65±6.08)%,14.98±3.04],Th2 was(4.08±0.73)%,which was significantly higher than that of the non-infected group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that postoperative bone trauma infection was signif

关 键 词：骨科创伤感染 骨科手术 中性粒细胞碱性磷酸酶 血清淀粉样蛋白A 辅助性T细胞 

分 类 号：R687[医药卫生—骨科学]