TLR4基因多态性及手术因素与老年骨折患者术后感染易感性的关联  

Correlation between TLR4 gene polymorphisms, surgical factors and susceptibility to postoperative infection in elderly patients with bone fractures

作　　者：贾欣 邬丽华 李婧茹 李艳红 连坤娜 李振涛 JIA Xin;WU Li-hua;LI Jing-ru;LI Yan-hong;LIAN Kun-na;LI Zhen-tao(Zhengzhou Health Vocational College,Zhengzhou,Henan 450121,China;不详)

机构地区：[1]郑州卫生健康职业学院,河南郑州450121 [2]新乡医学院附属郑州人民医院骨科,河南郑州453004

出　　处：《中华医院感染学杂志》2022年第10期1524-1527,共4页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191147)。

摘　　要：目的 探讨Toll样受体4(TLR4)基因多态性及手术因素与老年骨折患者术后感染易感性的关系。方法 选取2017年6月-2020年6月新乡医学院附属郑州人民医院收治的老年髋部骨折术后切口感染患者46例(感染组),另选取同期行手术治疗术后非感染患者103例(非感染组),分析切口感染病原菌分布,分析两组手术相关因素以及TLR4基因Asp299Gly(A/G)和Thr399Ile(C/T)位点基因型。结果 感染组患者共分离病原菌52株,其中革兰阴性菌32株、革兰阳性菌18株、真菌2株;感染组老年髋部骨折患者参观手术人数(>3人)、术中出血量(≥1 000 ml)占比均高于非感染组(P<0.05),而两组患者手术室类型、手术室空气含菌量、手术时间比较差异均无统计学意义;感染组和非感染组患者外周血TLR4基因Asp299Gly(A/G)和Thr399Ile(C/T)位点基因型分布比较无统计学差异;参观手术人数、术中出血量是老年髋部骨折患者术后切口感染的独立危险因素(P<0.05)。结论 TLR4基因Asp299Gly(A/G)和Thr399Ile(C/T)位点多态性与老年髋部骨折患者术后切口感染无明显关系,参观手术人数和术中出血量会增加术后切口感染风险。OBJECTIVE To explore the relationship between Toll-like receptor 4(TLR4) gene polymorphisms, surgical factors and susceptibility to postoperative infection in elderly patients with bone fractures. METHODS A total of 46 elderly patients with hip fractures who had postoperative incision infection and were treated in the Zhengzhou People′s Hospital Affiliated to Xinxiang Medical College from Jun 2017 to Jun 2020 were assigned as the infection group, meanwhile, 103 patients who did not have infection after surgical procedures were assigned as the no infection group. The distribution of the pathogens causing incision infection was observed, and the surgery-related factors and the genotypes at Asp299 Gly(A/G) and Thr399 Ile(C/T) loci of TLR4 gene were analyzed. RESULTS Totally 52 strains of pathogens were isolated from the patients of the infection group, 32 of which were gram-negative bacteria, 18 were gram-positive bacteria, and 2 were fungi. The proportions of the elderly hip fracture patients with more than 3 people observing surgery and intraoperative hemorrhage volume no less than 1000 ml were higher in the infection group than in the no infection group(P<0.05), however, there were no significant differences in the type of operating room, bacterial colony counts in the air of operating room and operation duration between the two groups of patients. There was no significant difference in the distribution of genotypes at Asp299 Gly(A/G) and Thr399 Ile(C/T) loci of peripheral blood TLR4 gene between the infection group and the no infection group. The number of people observing surgery and intraoperative hemorrhage volume were the independent risk factors for the postoperative incision infection in the elderly patients with hip fractures(P<0.05). CONCLUSION There is no significant relationship between the polymorphisms at Asp299 Gly(A/G) and Thr399 Ile(C/T) loci of TLR4 gene and the postoperative incision infection in the elderly patients with hip fractures. The number of people observing surgery and intraoperative

关 键 词：老年骨折患者 术后感染 TOLL样受体4 基因多态性 手术因素 

分 类 号：R619.3[医药卫生—外科学]