急性肾盂肾炎患者病原菌分布和血清YKL-40、IL-8表达的关系  

The relationship between pathogenic bacteria distribution and the expression of serum YKL-40 and IL-8 in patients with acute pyelonephritis

作　　者：张玲[1] 李益明 王志芳 姜金孝 金莎 祝亮 鲁庆红 陈健[2] ZHANG Ling;LI Yi-ming;WANG Zhi-fang;JIANG Jin-xiao;JIN Sha;ZHU Liang;LU Qing-hong;CHEN Jian(Department of Nephrology,Huanggang Central Hospital of Yangtze University,Huanggang,Hubei 438000,China;不详)

机构地区：[1]长江大学附属黄冈市中心医院肾病学科,湖北438000 [2]湖北省鄂东医疗集团黄石市中心医院肾内科

出　　处：《中国微生态学杂志》2022年第10期1186-1190,1196,共6页Chinese Journal of Microecology

基　　金：湖北省卫生健康委2019年度第三批联合基金面上项目(WJ2019H456);2021年黄冈市市本级科技计划项目一般项目(XQYF2021000005)。

摘　　要：目的探究急性肾盂肾炎(APN)患者病原菌分布与几丁质酶3样蛋白1(YKL-40)、白介素-8(IL-8)水平的关系。方法选取2016年1月至2020年12月我院诊治的138例APN患者为APN组,选取同期我院体检健康者138例为健康组。APN患者进行中段尿病原菌检测,采用全自动生化仪测定血清血尿素氮(BUN)、肌酐(Cr)水平;采用酶联免疫吸附法(ELISA)测定YKL-40、IL-8、胱抑素C(CysC)水平。按APN患者发作次数分为首发组(初次发作,90例)、复发组(多次发作,48例),比较不同类型APN患者血清YKL-40、IL-8、BUN、Cr、CysC水平;分析不同类型APN患者中段尿病原菌分布情况;比较不同病原菌感染APN患者血清YKL-40、IL-8、BUN、Cr、CysC水平;采用Pearson法分析不同病原菌感染APN患者血清YKL-40、IL-8水平与CysC水平的相关性。结果APN组患者血清YKL-40、IL-8、CysC水平均显著高于健康组(均P<0.05)。复发组患者血清YKL-40、IL-8、BUN、Cr、CysC水平与首发组差异无统计学意义(均P>0.05)。复发组患者病原菌阳性率为83.33%,显著高于首发组的52.22%(P<0.05)。87例病原菌阳性APN患者共培养出94株病原菌,首发组、复发组分别占52.13%、47.87%。两组APN患者均以革兰阴性菌为主,主要为大肠埃希菌。革兰阴性菌感染APN患者血清YKL-40、IL-8、CysC水平均高于革兰阳性菌感染者(均P<0.05)。革兰阴/阳性菌感染APN患者血清YKL-40、IL-8水平与CysC以及血清YKL-40水平与IL-8均呈正相关(均P<0.05)。结论YKL-40、IL-8在APN患者血清中水平较高,尤其在感染革兰阴性菌的患者中,临床可结合APN患者血清YKL-40、IL-8水平及其感染情况给予适当的治疗方案。Objective To explore the relationship between pathogenic bacteria infection and levels of chitinase-3-like protein-1(YKL-40)and interleukin-8(IL-8)in patients with acute pyelonephritis(APN).Methods A total of 138 APN patients diagnosed and treated in our hospital from January 2016 to December 2020 were enrolled as APN group,and 138healthy individuals receiving physical examination during the same period were enrolled as health group.The mid-stream urine pathogen detection was carried out;automatic biochemical analyzer was used to measure serum blood urea nitrogen(BUN)and creatinine(Cr)levels;enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of YKL-40,IL-8 and cystatin C(CysC).According to the number of episodes of the patients,they were divided into first-onset group(patients with first onset,90 cases)or recurrence group(patients with multiple onsets,48 cases),their serum YKL-40,IL-8,BUN,Cr,CysC levels were compared;the distribution of pathogenic bacteria in the urine of different types of APN patients was analyzed;the serum levels of YKL-40,IL-8,BUN,Cr and CysC in APN associated with different pathogens were compared.The correlation between serum levels of YKL-40 and IL-8 and that of CysC in APN associated with different pathogens was analyzed using Pearson method.Results The levels of serum YKL-40,IL-8 and CysC in the APN group were significantly higher than those in the health group(all P<0.05);the levels of serum YKL-40,IL-8,BUN,Cr and CysC in the recurrence group were not significantly different from those in the first-onset group(all P>0.05).The positive rate of pathogenic bacteria in the recurrence group was 83.33%,significantly higher than the 52.22%in the first-onset group(P<0.05).A total of 94 pathogens were isolated from 87 pathogen-positive APN patients,52.13%in the first-onset group and 47.87%in the recurrence group,respectively.The two groups of APN patients were mainly Gram-negative bacteria infected,mainly Escherichia coli.The serum levels of YKL-40,IL-8 and CysC of APN patien

关 键 词：急性肾盂肾炎 几丁质酶3样蛋白1 病原菌 白介素-8 

分 类 号：R691.3[医药卫生—泌尿科学]