结直肠癌术后腹腔感染危险因素及与UGT1A1*28位点基因多态性的关联  

Risk factors for postoperative abdominal infection in colorectal cancer patients and association with gene polymorphisms at UGT1A1*28 locus

作　　者：李昂[1] 周毕军[2] 陈中建[3] 朱万里[4] 魏蓓蕾 LI Ang;ZHOU Bi-jun;CHEN Zhong-jian;ZHU Wan-li;WEI Bei-lei(The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473000,China;不详)

机构地区：[1]南阳医学高等专科学校第一附属医院肛肠外科,河南南阳473000 [2]南阳医学高等专科学校临床医学系,河南南阳473000 [3]南阳医学高等专科学校第一附属医院普外四科,河南南阳473000 [4]南阳医学高等专科学校第一附属医院普外一科,河南南阳473000 [5]南阳医学高等专科学校第一附属医院泌尿男科,河南南阳473000

出　　处：《中华医院感染学杂志》2022年第13期2015-2019,共5页Chinese Journal of Nosocomiology

基　　金：河南省重点研发计划基金资助项目(2019GSF3218019)。

摘　　要：目的探究结直肠癌术后腹腔感染的危险因素及与尿苷二磷酸葡醛酰转移酶(UGT1A1)*28位点基因多态性的关联。方法以2016年3月-2020年10月南阳医学高等专科学校第一附属医院153例结直肠癌患者为研究对象,根据术后腹腔感染发生情况分为感染组39例和未感染组114例,感染组患者进行病原菌培养,收集两组患者一般资料及临床资料,并测定外周血UGT1A1*28位点基因多态性。结果39例腹腔感染患者共检出42株病原菌,以革兰阴性菌为主,占比76.19%;感染组合并糖尿病、贫血、术前肠梗阻、术前美国麻醉医生协会(ASA)评分为3~4分、肿瘤分期为Ⅱ~Ⅳ期、手术时间≥2 h、发生吻合口漏、引流管留置时间≥10 d、住院时间≥20 d、未使用抗菌药物的比例高于未感染组(P<0.05);多因素分析显示合并糖尿病、术前肠梗阻、手术时间≥2 h、引流管留置时间≥10 d是导致结直肠癌患者术后出现腹腔感染的危险因素(P<0.05);感染组及未感染组UGT1A1*28位点基因型对比,无统计学差异;UGT1A1*28位点基因多态性与结直肠手术后感染无关联。结论合并糖尿病、术前肠梗阻、手术时间≥2 h、引流管留置时间≥10 d是导致结直肠癌患者术后出现腹腔感染的危险因素,UGT1A1*28位点基因多态性与结直肠癌术后感染无关联。OBJECTIVE To explore the risk factors for postoperative abdominal infection in patients with colorectal cancer and analyze the association with gene polymorphisms at uridine diphosphate glyoxyltransferase(UGT1 A1)*28 locus.METHODS Totally 153 patients with colorectal cancer who were treated in the First Affiliated Hospital of Nanyang Medical College from Mar 2016 to Oct 2020 were recruited as the study subjects and divided into the infection group with 39 cases and the no infection group with 114 cases according to the status of postoperative abdominal infection.The culture of pathogens was carried out for the patients in the infection group,the baseline data and clinical data were collected form the two groups of patients,and the gene polymorphisms at UGT1 A1*28 locus were determined.RESULTS Totally 42 strains of pathogens were isolated from 39 patients with abdominal infection,76.19%of which were gram-negative bacteria.The percentages of patients with diabetes mellitus,anemia,preoperative intestinal obstruction,preoperative American Society of Anesthesiologists(ASA)score ranging between 3 and 4 points,tumor staging ranging between stage II and IV,operation duration no less than 2 h,anastomotic leakage,drainage tube indwelling time no less than 10 days,length of hospital stay no less than 20 days and without use of antibiotics were significantly higher in the infection group than in the no infection group(P<0.05).Multivariate analysis showed that the complication with diabetes mellitus,preoperative intestinal obstruction,operation duration no less than 2 hours and drainage tube indwelling time no less than 10 days were the risk factors for the postoperative abdominal infection in the colorectal cancer patients(P<0.05).There were no significant differences in the genotypes at UGT1 A1*28 locus between the infection group and the no infection group.The gene polymorphisms at UGT1 A1*28 locus were not associated with the postoperative infection in the colorectal cancer patients.CONCLUSION The complication with diabet

关 键 词：结直肠癌 术后感染 腹腔感染 病原菌 危险因素 尿苷二磷酸葡醛酰转移酶*28位点基因多态性 关联 

分 类 号：R735.35[医药卫生—肿瘤]