产妇导尿后尿路感染特征与SP-D基因多态性的关系  

Relationship between SP-D gene polymorphisms and characteristics of urinary tract infection after catheterization in parturients

作　　者：霍津 王风 田元元 布阿吉·肉孜 张玉琴 李祥雯[1] HUO Jin;WANG Feng;TIAN Yuanyuan;Buaji Rouzi;ZHANG Yuqin;LI Xiangwen(The First Department of Obstetrics,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院产一科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2023年第3期357-362,367,共7页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2019D01C317)。

摘　　要：目的 分析产妇导尿后尿路感染特征与表面活性蛋白-D(SP-D)基因多态性的关系。方法 选取本院于2019年7月-2021年4月收治的562例产妇为研究对象。收集产妇导尿后尿路感染(UTI)患者的尿液送检,进行病原菌和耐药性分析;根据是否发生UTI将产妇分为感染组(76例)和未感染组(486例),采用单因素和多因素Logistic回归分析法分析产妇导尿后UTI的影响因素,采用序列特异性引物-聚合酶链反应检测UTI患者SP-D-Thr11Met、SP-D-Thr160Ala外显子位点的SP-D基因多态性,分析SP-D基因多态性与UTI易感性的关系。结果 562例产妇导尿后发生UTI有76例,尿液中检出致病菌114株,其中,革兰阴性菌79株,占69.30%,革兰阳性菌28株,占24.56%,真菌7株,占6.14%。大肠埃希菌、肺炎克雷伯菌和变形菌属等革兰阴性菌对亚胺培南、美罗培南的耐药率为0.00%;肠球菌属和凝固酶阴性葡萄球菌等革兰阳性菌对万古霉素、替考拉宁的耐药率为0.00%。年龄>35岁、体质指数>30 kg/m2、妊娠期糖尿病、分娩方式为剖宫产、导尿次数>2次、留置导尿时间>2 d、血红蛋白≤110 g/L、既往UTI史、SP-D>100 nmol/L是影响产妇导尿后UTI的独立危险因素(P<0.05)。两组SP-D-Thr11Met位点的各基因型频率以及11Met和11Thr等位基因的频率比较,差异无统计学意义(P>0.05),两组SP-D-Thr160Ala位点的各基因型频率以及160Thr和160Ala等位基因的频率比较,差异无统计学意义(P>0.05)。结论 产妇导尿后UTI的病原菌以革兰阴性菌为主,病原菌具有多药耐药性的特点;外周血中SP-D>100 nmol/L是影响产妇导尿后UTI的独立危险因素,但外周血中SP-D外显子区域SP-D-Thr11Met和SP-D-Thr160Ala的基因与UTI的易感性无关。Objective To analyze the relationship between characteristics of urinary tract infection and polymorphisms of surfactant protein-D(SP-D)gene in puerperae after catheterization.Methods A total of 562 puerperae admitted to the hospital were enrolled as research objects from July 2019 to April 2021.The urine samples from UTI patients after catheterization were collected for analysis of pathogens and resistance.According to presence or absence of UTI,the patients were divided into infection group(76 cases)and non-infection group(486 cases).The influencing factors of UTI after catheterization were analyzed by univariate and multivariate Logistic regression analysis.The polymorphisms of SP-D gene were detected by sequence specific primer-polymerase chain reaction.The relationship between SP-D gene polymorphisms and UTI susceptibility was analyzed.Results In 562 puerperae after catheterization,there were 76 cases with UTI.There were 114 strains of pathogens in urine samples,including 79 strains of Gram-negative bacteria(69.30%),28 strains of Gram-positive bacteria(24.56%)and 7 strains of fungi(6.14%).The resistance rates of Gram-negative bacteria(Escherichia coli,Klebsiella pneumoniae,Proteobacteria)to imipenem and meropenem were all 0.00%.The resistance rates of Gram-positive bacteria(Enterococcus,coagulase-negative Staphylococci)to vancomycin and teicoplanin were all 0.00%.Age>35 years,body mass index>30 kg/m2,gestational diabetes mellitus,cesarean section,catheterization>twice,indwelling catheter time>2 d,hemoglobin≤110 g/L,previous UTI history and SP-D>100 nmol/L were independent risk factors of UTI after catheterization(P<0.05).There was no significant difference in frequencies of different genotypes at SP-D-Thr 11Met locus,or the frequencies of alleles at 11Met and 11Thr loci between the two groups(P>0.05),and the difference in frequencies of genotypes at SP-DThr160Ala locus,and frequencies of alleles at 160Thr and 160Ala loci were not statistically significant(P>0.05).Conclusion The main pathogen of UTI is Gram

关 键 词：产妇 导尿 尿路感染 表面活性蛋白-D 基因多态性 

分 类 号：R691.3[医药卫生—泌尿科学]