胃癌根治术后感染影响因素及NF-κB、MCP-1表达和肠道微生态与肠道屏障功能的关系  

Influencing factors for postoperative infection in gastric cancer undergoing radical resection and association between expressions of NF-κB,MCP-1,intestinal microecology with intestinal barrier function

作　　者：顾晓会 盛丹 邹萌 李奇蒙[4] 王晓驰 GU Xiao-hui;SHENG Dan;ZOU Meng;LI Qi-meng;WANG Xiao-chi(Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110000,China)

机构地区：[1]中国医科大学附属盛京医院第三普通外科胃肠营养皮肤科病房,辽宁沈阳110000 [2]中国医科大学附属盛京医院第二泌尿外科病房,辽宁沈阳110000 [3]中国医科大学附属盛京医院第二普通外科胆道、整形美容外科病房,辽宁沈阳110000 [4]中国医科大学附属盛京医院第三感染性疾病肝病病房,辽宁沈阳110000 [5]中国医科大学附属盛京医院第四普通外科结直肠肿瘤外科病房,辽宁沈阳110000

出　　处：《中华医院感染学杂志》2023年第10期1512-1516,共5页Chinese Journal of Nosocomiology

基　　金：辽宁省科研基金资助项目(2020L0801)。

摘　　要：目的探讨胃癌根治术后感染影响因素及血清核因子κB(NF-κB)、单核细胞趋化蛋白-1(MCP-1)表达及肠道微生态和肠道屏障功能的关系。方法选取2018年6月-2021年6月于中国医科大学附属盛京医院行胃癌根治术患者108例,根据是否出现术后感染分为感染组21例和未感染组87例。无菌采集患者痰液、中段尿、粪便及皮肤创面分泌物行病原菌分离鉴定,收集患者术后首次新鲜粪便行肠道菌群检测。采用酶联免疫法检测血清D乳酸、二胺氧化酶(DAO)、NF-κB、MCP-1水平;多因素Logistic回归分析胃癌根治术患者术后感染影响因素;Pearson相关性分析胃肠道菌群分布与肠道屏障功能指标的关系。结果胃癌根治术后感染患者分离病原菌以肺炎克雷伯菌为主;年龄≥60岁、合并糖尿病和住院时间≥14 d为胃癌根治术患者术后感染的独立影响因素(P<0.05);感染组胃肠道大肠埃希菌菌落数量高于未感染组,双歧杆菌数量低于未感染组(P<0.05);感染组患者血清D乳酸、DAO水平低于未感染组,血清NF-κB、MCP-1水平高于未感染组(P<0.05);Pearson相关性分析,感染组大肠埃希菌菌落数量和D乳酸、DAO水平呈正相关,双歧杆菌数量和D乳酸、DAO水平呈负相关(P<0.05)。结论胃癌根治术术后感染患者血清NF-κB、MCP-1水平显著升高,其胃肠道菌群分布与肠道屏障功能密切相关。OBJECTIVE To explore the influencing factors for postoperative infection in gastric cancer patients undergoing radical resection and analyze the association of expressions of serum nuclear factorκB(NF-κB),monocyte chemoattractant protein-1(MCP-1),intestinal microecology with intestinal barrier function.METHODS Totally 108 gastric cancer patients who underwent radical resection in Shengjing Hospital Affiliated to China Medical University from Jun 2018 to Jun 2021 were enrolled in the study and divided into the infection group with 21 cases and the 87 cases according to the status of postoperative infection.The sputum,midstream urine,stool and skin wound secretion specimens were collected from the patients by aseptic means,the pathogens were isolated and identified,the fresh stool specimens were collected from the patients when they defecated for the first time after surgery so as to detect the intestinal flora.The levels of serum D-lactate,diamine oxidase(DAO),NF-κB and MCP-1 were detected by enzyme-linked immunosorbent assay.Multivariate logistic regression analysis was carried out for the influencing factors for the postoperative infection,and Pearson correlation analysis was performed for the relationship between the gastrointestinal flora and the intestinal barrier function indexes.RESULTS Klebsiella pneumoniae was dominant among the pathogens that were isolated from the patients with postoperative infection.The no less than 60 years of age,complication with diabetes mellitus and length of hospital stay no less than 14 days were independent influencing factors for the postoperative infection in the gastric cancer patients undergoing radical resection(P<0.05).The gastrointestinal tract colony counts of Escherichia coli of the infection group were higher than those of the no infection group,while the colony counts of Bifidobacteria of the infection group were lower than those of the no infection group(P<0.05).The levels of serum D-lactate and DAO of the infection group were lower than those of the no infectio

关 键 词：胃癌根治术 术后感染 核因子ΚB 单核细胞趋化蛋白-1 胃肠道菌群分布 肠道屏障功能 影响因素 

分 类 号：R619.3[医药卫生—外科学]