脊柱手术术后深部感染Nrf2/HO-1/NQO1信号通路表达及其预后  

Expression of Nrf2/HO-1/NQO1 signaling pathways in spinal surgery patients with postoperative deep infection and prognosis

作　　者：戚记伟[1] 刘艳萍 王拓[1] 许世超[1] 李强 QI Ji-wei;LIU Yan-ping;WANG Tuo;XU Shi-chao;LI Qiang(Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine(Xiaoshan Hospital of Traditional Chinese Medicine),Hangzhou,Zhejiang 31120l,China)

机构地区：[1]浙江中医药大学附属江南医院(杭州市萧山区中医院)骨科,浙江杭州311201 [2]浙江中医药大学附属江南医院(杭州市萧山区中医院)外科,浙江杭州311201

出　　处：《中华医院感染学杂志》2022年第10期1528-1532,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划项目(2020KY796)。

摘　　要：目的 探讨脊柱手术术后深部感染患者核因子E2相关因子2(Nrf2)/血红素氧合酶-1(HO-1)/醌氧化还原酶1(NQO1)信号通路表达及其预后。方法 选取2014年10月-2020年10月浙江中医药大学附属江南医院收治的脊柱手术术后深部感染患者62例(深部感染组),另选取同期脊柱手术术后未感染患者64例(非感染组),比较两组患者血清Nrf2、HO-1、NQO1表达水平及其对深部感染预后的评估价值。结果 深部感染组患者血清Nrf2、HO-1、NQO1水平均低于非感染组(P<0.05),术后深部感染患者共检出病原菌68株,其中革兰阳性菌38株、革兰阴性菌28株、真菌2株,革兰阳性菌以金黄色葡萄球菌和表皮葡萄球菌为主,革兰阴性菌以大肠埃希菌和铜绿假单胞菌为主;深部感染预后不良组患者血清Nrf2、HO-1、NQO1水平均低于预后良好组(P<0.05),血清Nrf2、HO-1和NQO1水平预测深部感染患者预后不良的曲线下面积(AUC)分别为0.854、0.736、0.812。结论 脊柱手术术后深部感染病原菌以革兰阳性菌为主,脊柱手术术后深部感染及预后不良患者血清中Nrf2、HO-1、NQO1呈低表达,其表达水平对术后深部感染患者预后不良有较好的预测价值。OBJECTIVE To explore the expression of nuclear factor erythroid-2-related factor2(Nrf2)/heme oxygenase-1(HO-1)/NADPH quinone oxidoreductase 1(NQO1) signaling pathways in spinal surgery patients with postoperative deep infection and analyze their relationship with prognosis. METHODS A total of 62 patients who underwent spinal surgery and had postoperative deep infection in the Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from Oct 2014 to Oct 2020 were assigned as the deep infection group, meanwhile, 64 patients who underwent spinal surgery but did not have postoperative infection were chosen as the no infection group. The expression levels of serum Nrf2, HO-1 and NQO1 were compared between the two groups of patients, and the values of the indexes in assessment of the prognosis of the patients with deep infection were observed. RESULTS The levels of serum Nrf2, HO-1 and NQO1 of the deep infection group were lower than those of the no infection group(P<0.05). Totally 68 strains of pathogens were isolated from the patients with postoperative deep infection, 38 of which were gram-positive bacteria, 28 were gram-negative bacteria, and 2 were fungi. Staphylococcus aureus and Staphylococcus epidermidis were the predominant species of gram-positive bacteria;Escherichia coli and Pseudomonas aeruginosa were dominant among the gram-negative bacteria. Among the patients with deep infection, the levels of serum Nrf2, HO-1 and NQO1 of the poor prognosis group were lower than those of the favorable prognosis group(P<0.05). The areas under curves(AUCs) of the serum Nrf2, HO-1 and NQO1 were respectively 0.854, 0.736 and 0.812 in prediction of poor prognosis of the patients with deep infection. CONCLUSION The gram-positive bacteria are dominant among the pathogens causing the postoperative deep infection in the spinal surgery patients. The spinal surgery patients with postoperative deep infection and poor prognosis show low expression levels of serum Nrf2, HO-1 and NQO1, and the expression lev

关 键 词：脊柱手术 切口深部感染 核因子E2相关因子2 血红素氧合酶-1 醌氧化还原酶1 预测价值 

分 类 号：R619.3[医药卫生—外科学]