剖宫产术后感染患者病原菌分布及对TGF-β1/Smads通路信号表达的影响  

Distribution of infection pathogens and its influences on TGF-β1/Smads signaling pathways in patients after cesarean section

作　　者：王芳 涂春燕 凌艳娟 陈雪梅 WANG Fang;TU Chunyan;LING Yanjuan;CHEN Xuemei(Ziyang First People's Hospital,Ziyang 641399,China)

机构地区：[1]四川省资阳市第一人民医院,641399

出　　处：《中国煤炭工业医学杂志》2023年第4期378-384,共7页Chinese Journal of Coal Industry Medicine

基　　金：四川省医学科研课题计划(编号:S20052)。

摘　　要：目的 探讨剖宫产术后感染患者病原菌分布特征,分析TGF-β1/Smads通路信号的表达及意义。方法选取2019年4月—2022年8月该院收治的62例剖宫产术后感染患者为感染组,另选取本院同期收治的62例剖宫产术后未合并感染的患者为非感染组。收集所有研究对象的临床资料,对感染组患者进行病原菌鉴定,检测并比较两组外周血单个核细胞转化生长因子β1(TGF-β1)、Smad2、Smad3m RNA相对表达水平,通过受试者工作特征曲线(ROC)参数分析法探讨外周血单个核细胞TGF-β1、Smad2、Smad3m RNA相对表达水平对剖宫产患者术后感染发生的诊断价值,以ROC的截断值进行二分类,然后通过Logistic分析其与术后感染的关系。结果 本组62例剖宫产术后感染患者中,感染部位主要为手术切口(43.55%),其次为生殖系统(19.35%)、呼吸系统(16.13%)分离出83株病原菌中,以革兰阴性菌占比最高,为75.90%,以铜绿假单胞菌(33.73%)位居首位;革兰阳性菌其次占20.48%,真菌则占3.61%;感染组年龄大于非感染组,手术时间长于非感染组,妊娠期糖尿病、导尿管拔管时间≥24h比例高于非感染组,差异有统计学意义(P<0.05),感染组与未感染组民族、孕周、BMI、产次、流产次数、怀胎数及新生儿性别等方面比较无明显差异(P>0.05)。感染组患者的外周血单个核细胞TGF-β1、Smad2、Smad3 m RNA相对表达水平明显高于非感染组,差异有统计学意义(P<0.05),上述3项指标用于剖宫产患者术后感染发生诊断的AUC分别达0.706、0.644、0.678,3项指标比较差异无明显差异(P>0.05)。Logistic回归分析结果显示,年龄≥35岁、手术时间≥1h、TGF-β1mRNA相对表达水平>1.64、Smad2mRNA相对表达水平>2.82及Smad3mRNA相对表达水平>3.13是剖宫产患者术后感染发生的独立危险因素(P<0.05)。结论 剖宫产术后感染患者多为手术切口感染,主要致病菌为革兰阴性菌,TGF-β1/Smads信号通路激活是剖�Objective To explore the distribution characteristics of pathogens, and to analyze the expressions and significance of transforming growth factor-β1(TGF-β1)/Smads signaling pathways in infection patients after cesarean section. Methods Sixty-two patients with infection after cesarean section admitted to the hospital were enrolled as infection group between April 2019 and August 2022,while other sixty-two patients without infection during the same period were enrolled as non-infection group.The clinical data of all research objects were collected for pathogens identification.The relative expression levels of TGF-β1,Smad2 and Smad3 mRNA in peripheral blood mononuclear cells(PBMCs) in the two groups were detected and compared, and their diagnostic value for infection after cesarean section was explored by receiver operating characteristic(ROC) curves.Taking cut-off value of ROC curve as the dichotomy, their relationship with postoperative infection was analyzed by Logistic analysis. Results In the 62 patients with infection after cesarean section, the main infection sites included surgical incision(43.55%),followed by reproductive system(19.35%) and respiratory system(16.13%).Among the 83 strains of pathogens, proportion of Gram-negative bacteria was the highest(75.90%),mainly on Pseudomonas aeruginosa(33.73%).The proportions of Gram-positive bacteria and fungi were 20.48% and 3.61%,respectively.The age in infection group was older than that in non-infection group, operation time was longer than that in non-infection group, and proportions of gestational diabetes mellitus and catheter extubation time ≥24h were higher than those in non-infection group(P<0.05).There was no significant difference in nationality, gestational week, BMI,parity, times of abortion, times of pregnancy or neonatal genders between infection group and non-infection group(P>0.05).The relative expression levels of TGF-β1,Smad2 and Smad3 mRNA in PBMCs in infection group were significantly higher than those in non-infection group(P<0.05).AUC

关 键 词：剖宫产 术后感染 转化生长因子Β1 病原学 

分 类 号：R719.8[医药卫生—妇产科学]