下肢静脉曲张溃疡创面病原菌感染及血管内皮生长因子/Notch基因表达  

Pathogen infection and vascular endothelial growth factor/Notch gene expression in varicose ulcer of lower extremity

作　　者：杜建青[1] 张弘[1] 吴忠隐 李荣华[1] 汪立[1] Du Jianqing;Zhang Hong;Wu Zhongyin;Li Ronghua;Wang Li(Department of Vascular Surgery,Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院血管外科,067000

出　　处：《中华实验外科杂志》2022年第12期2425-2428,共4页Chinese Journal of Experimental Surgery

基　　金：承德市科学技术局(202006A82)。

摘　　要：目的:探讨下肢静脉曲张溃疡创面病原菌感染及耐药性变迁并分析感染对血管内皮生长因子(VEGF)/Notch基因表达的影响。方法:回顾性分析2011年1月至2020年12月承德医学院附属医院诊治的412例下肢静脉曲张溃疡患者临床资料,分为2011年1月至2015年12月组(A组)和2016年1月至2020年12月组(B组)。分析两组患者病原检出分布及耐药状况。实时荧光定量聚合酶链反应(RT-qPCR)和免疫组织化学链霉卵白素-生物素法(SP)法分别检测VEGF和Notch基因mRNA及蛋白表达。两组间均数比较采用t检验;计数资料比较采用χ^(2)检验或Fisher精确概率法。结果:A组和B组患者在革兰阳性菌、革兰阴性菌和真菌检出率的差异无统计学意义(χ^(2)=0.100、0.093、0.652,P>0.05)。B组患者金黄色葡萄球菌对青霉素G及头孢唑林耐药率显著高于A组患者(100.00%比70.59%、66.67%比29.41%),差异有统计学意义(χ^(2)=9.176、13.438,P<0.05)。B组患者表皮葡萄球菌对克林霉素及头孢唑林耐药率显著高于A组患者(69.23%比36.36%、84.62%比36.36%),差异有统计学意义(χ^(2)=7.654、9.533,P<0.05)。B组患者铜绿假单胞菌对氨苄西林、头孢唑林及头孢吡肟耐药率显著高于A组患者(93.10%比64.00%、82.76%比56.00%、58.62%比16.00%),差异有统计学意义(χ^(2)=8.778、10.632、9.125,P<0.05)。B组患者大肠埃希菌对氨苄西林、头孢唑林、哌拉西林、头孢吡肟耐药率显著高于A组患者(84.85%比57.14%、75.76%比42.86%、48.48%比19.05%、36.36%比9.52%),差异有统计学意义(χ^(2)=8.679、9.127、7.235、11.763,P<0.05)。感染患者VEGF和Notch基因mRNA相对表达量和蛋白表达阳性率均显著高于非感染患者(VEGF和Notch基因mRNA相对表达量分别为0.64±0.09比0.25±0.05、0.58±0.08比0.19±0.04,蛋白表达阳性率分别88.07%比76.38%、80.00%比63.78%),差异有统计学意义(t/χ^(2)=15.652、12.456、7.864、9.142,P<0.05)。结论:下肢静脉曲张患者溃疡创面Objective To investigate the bacterial infection and drug resistance changes of lower extremity varicose ulcer wounds,and to analyze the effect of infection on vascular endothelial growth factor(VEGF)/Notch gene expression.Methods The clinical data of 412 patients with varicose ulcer of lower extremity Jan 2011 to Dec 2020 were retrospectively analyzed,and they were divided into group A(from January 2011 to December 2015)and group B(From Jan 2016 to Dec 2020).The distribution of detected pathogens and drug resistance status of the two groups of patients were analyzed.Quantitative real-time polymerase chain reaction(RT-qPCR)and immunohistochemical streptavidin-biotin(SP)methods were used to detect VEGF and Notch gene mRNA and protein,respectively.The t test was used to compare the means between the two groups;theχ^(2) test or Fisher’s exact test was used to compare the enumeration data.Results The resistance rates of staphylococcus aureus to penicillin G and cefazolin in group B were significantly higher than those in group A(100%vs.70.59%,66.67%vs.29.41%,respectively),and the differences were statistically significant(χ^(2)=9.176,13.438,P<0.05).The resistance rates of staphylococcus epidermidis to clindamycin and cefazolin in group B were significantly higher than those in group A(69.23%vs.36.36%,84.62%vs.36.36%,respectively),and the difference was statistically significant(χ^(2)=7.654,9.533,P<0.05).The resistance rates of Pseudomonas aeruginosa in group B to ampicillin,cefazolin and cefepime were significantly higher than those in group A(93.10%vs.64.00%,82.76%vs.56.00%,58.62%vs.16.00%,respectively).There was statistical significance(χ^(2)=8.778,10.632,9.125,P<0.05).The resistance rates of escherichia coli to ampicillin,cefazolin,piperacillin,and cefepime in group B were significantly higher than those in group A(84.85%vs.57.14%,75.76%vs.42.86%,48.48%vs.19.05%,respectively,36.36%vs.9.52%),the difference was statistically significant(χ^(2)=8.679,9.127,7.235,11.763,P<0.05).The relative mRNA expression and p

关 键 词：下肢静脉曲张 病原 血管内皮生长因子 NOTCH 

分 类 号：R543.6[医药卫生—心血管疾病]