前列腺增生术后医院感染影响因素及与维生素D受体基因多态性关系  

Influencing factors for nosocomial infection in patients with benign prostatic hyperplasia after surgery and its relationship with the polymorphisms of vitamin D receptor gene

作　　者：厉波 胡明森 高兴超 焦光娟 宋景国 LI Bo;HU Ming-sen;GAO Xing-chao;JIAO Guang-juan;SONG Jing-guo(Rizhao Central Hospital,Rizhao,Shandong 276800,China;不详)

机构地区：[1]日照市中心医院泌尿外科,山东日照276800 [2]日照市中心医院重症医学科,山东日照276800 [3]日照市中心医院麻醉科,山东日照276800 [4]日照市中心医院产科,山东日照276800 [5]日照市中心医院影像科,山东日照276800

出　　处：《中华医院感染学杂志》2021年第15期2342-2346,共5页Chinese Journal of Nosocomiology

基　　金：山东省科研基金资助项目(20191214111)。

摘　　要：目的研究前列腺增生患者术后医院感染的影响因素及其与维生素D受体(VDR)基因多态性的关系。方法收集2016年1月-2019年6月日照市中心医院收治行经尿道电切术治疗的前列腺增生患者150例,统计患者术后感染发生情况及感染病原菌分布;按是否发生医院感染分为感染组与非感染组,比较两组临床资料的差异及VDR基因启动子FokI位点单核苷酸多态性,筛选前列腺增生术后医院感染的高危因素,探究VDR启动子FokI基因多态性分布与前列腺增生术后医院感染易感性的关系。结果150例前列腺增生患者术后发生感染35例,感染率为23.33%;其中泌尿系统感染30例占85.71%,呼吸系统感染3例占8.57%,消化系统感染2例占5.71%;共检出病原菌61株,病原菌以革兰阴性菌为主,占81.97%;感染组携带ff基因型及f等位基因频率所占比例高于非感染组(P<0.05);年龄、合并糖尿病、前列腺大小、术前导尿、灌洗液温度、手术时间、术后留置尿管时间、住院时间、VDR Fok I位点基因型分布均为前列腺增生术后医院感染发生的危险因素(P<0.05),术前应用抗菌药物、术者操作年限为其保护因素。结论前列腺增生患者术后医院感染风险大,高龄、合并糖尿病、前列腺体积大、术前导尿、灌洗液温度偏低、手术时间长、留置尿管时间长、住院时间长及携带VDR启动子FokI位点ff基因型均为术后医院感染发生的高危因素;需积极控制上述危险因素,强化临床护理。OBJECTIVE To study the influencing factors for nosocomial infection in patients with benign prostatic hyperplasia after surgery,and its relationship with the polymorphisms of vitamin D receptor(VDR)gene.METHODS During Jan 2016 and Jun 2019,150 patients with benign prostatic hyperplasia undergoing transurethral resection in Rizhao Central Hospital were enrolled in this study,and the incidence of postoperative infection and pathogenic bacteria distribution were statistically analyzed.All subjects were divided into the infected group and uninfected group according to the presence or absence of nosocomial infection.Clinical data and single nucleotide polymorphisms of VDR gene promoter FokI between the two groups were compared.The high-risk factors for the nosocomial infection after benign prostatic hyperplasia surgery were screened out.The relationship between VDR promoter FokI gene polymorphisms and susceptibility to nosocomial infection after benign prostatic hyperplasia surgery was discussed.RESULTS Thirty-five cases in 150 patients were infected after surgery,with the infection rate of 23.33%.Among them,there were 30 cases with urinary system infection(85.71%),3 cases with respiratory system infection(8.57%),and 2 cases with digestive system infection(5.71%).Sixty-one strains were detected,in which Gram-negative bacteria were the main pathogens,accounting for 81.97%.The frequency of ff genotype and f allele in the infected group was significantly higher than that in the uninfected group(P<0.05).Age,diabetes,prostate size,preoperative urinary catheterization,lavage fluid temperature,operation time,postoperative catheter indwelling time,hospital stay,and VDR Fok I locus genotype distribution were risk factors for nosocomial infection after benign prostatic hyperplasia surgery(P<0.05),while use of antibacterial drugs before surgery and the operator’s operating years were protective factors.CONCLUSION Patients with benign prostatic hyperplasia have a higher risk of nosocomial infection after surgery.Advanced age,di

关 键 词：前列腺增生 感染 影响因素 维生素D受体 单核苷酸多态性 

分 类 号：R619.3[医药卫生—外科学]