TGF-β1/Smads信号通路激活与血液透析导管相关性血流感染的关联  

Relationship between activation of TGF-β1/Smads signaling pathway and catheter-related bloodstream infection in hemodialysis

作　　者：赖贻旺 张竹华 陈贵辽 郑雪敏 隋超 LAI Yi-wang;ZHANG Zhu-hua;CHEN Gui-liao;ZHENG Xue-min;SUI Chao(Zhangzhou Third Hospital,Zhangzhou,Fujian 363000,China;不详)

机构地区：[1]漳州市第三医院肾内科,福建漳州363000 [2]漳州市第三医院感染性疾病科,福建漳州363000 [3]厦门大学附属东南医院肾脏内科,福建厦门363000

出　　处：《中华医院感染学杂志》2022年第16期2420-2424,共5页Chinese Journal of Nosocomiology

基　　金：福建省自然科学基金资助项目(2019J429)。

摘　　要：目的分析转化生长因子-β1(TGF-β1)/Smads信号通路与血液透析发生导管相关性血流感染(CRBSI)的关系。方法选取漳州市第三医院2018年1月-2021年1月进行血液透析的患者,按CRBSI情况分为感染组47例与对照组46例;分析患者发生CRBSI的相关影响因素、导致感染的病原菌类型、血清炎症因子表达水平以及TGF-β1和Smad2、Smad4的蛋白表达水平。结果感染组的穿刺次数、合并糖尿病例数、导管留置时间高于对照组(P<0.05),感染组血清白蛋白水平低于对照组(P<0.05);感染组患者的肿瘤坏死因子-α(TNF-α),白细胞介素-8(IL-8)以及TGF-β1表达水平均高于对照组(P<0.05);感染组患者的TGF-β1、Smad2及Smad3蛋白表达水平均高于对照组患者(P<0.05);Logistic逐步回归分析发现,穿刺次数、合并糖尿病、导管留置时间、白蛋白表达水平、血清TNF-α、IL-8及TGF-β1表达水平和血清TGF-β1、Smad2及Smad3蛋白表达水平均是血液透析治疗患者发生CRBSI的影响因素(P<0.05)。结论CRBSI发生的影响因素包括TGF-β1高表达和血清TGF-β1、Smad2、Smad3蛋白高表达等;CRBSI会激活TGF-β1/Smads信号通路,诱使机体释放大量炎症因子,对患者造成严重损伤,加重患者组织器官纤维化。OBJECTIVE To analyze the relationship between transforming growth factor-beta 1(TGF-β1)/Smads signaling pathway and catheter-related bloodstream infection(CRBSI)in hemodialysis.METHODS Patients who underwent hemodialysis in the Third Hospital in Zhangzhou from Jan 2018 to Jan 2021 were recruited,and divided into the infected group(47 cases)and control group(46 cases)according to whether CRBSI occurred.The risk factors for CRBSI,type of pathogenic bacteria causing the infection,serum levels of inflammatory factors and protein expression levels of transforming growth factor 1(TGF-β1),Smad2 and Smad4 were analyzed.RESULTS The times of puncture,number of cases complicated with diabetes and catheter indwelling time in the infected group were significantly higher than those in the control group(P<0.05),the serum albumin level of the infected group was lower than that of the control group(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and TGF-1 in the infected group were significantly higher than those in the control group(P<0.05).The protein expression levels of TGF-β1,Smad2 and Smad3 in the infected group were significantly higher than those in the control group(P<0.05).Logistic stepwise regression analysis found that the time of puncture,diabetes,catheter indwelling time,albumin level,serum levels of TNF-α,IL-8 and TGF-β1,and protein expression levels of TGF-β1,Smad2 and Smad3 were independent risk factors for CRBSI in patients undergoing hemodialysis(P<0.05).CONCLUSION High expression of TGF-β1,serum TGF-β1,Smad2 and Smad3 are risk factor for CRBSI,which induce the activation of TGF-β1/Smads signaling pathway and stimulate the body to release a large number of inflammatory factors,causing severe damage and aggravating fibrosis of tissues and organs in the patients.

关 键 词：导管相关性血流感染 血液透析 终末期肾脏病 TGF-β1/Smads信号通路 

分 类 号：R692[医药卫生—泌尿科学]