老年前列腺增生术后尿路感染危险因素及其对TGF-β1/Smads信号通路的影响  

Risk factors for postoperative urinary tract infections in elderly patients with benign prostatic hyperplasia and influence on TGF-β1/Smads signaling pathways

作　　者：郭绍洪 程庆[2] 蔡笃森 黄家伟 陈金山 GUO Shao-hong;CHENG Qing;CAI Du-sen;HUANG Jia-wei;CHEN Jin-shan(Hainan Second People's Hospital,Wuzhishan,Hainan 572299,China;不详)

机构地区：[1]海南省第二人医院泌尿外科,海南五指山572299 [2]中南大学湘雅医学院附属海口医院泌尿外科,海南海口570208

出　　处：《中华医院感染学杂志》2023年第13期1991-1995,共5页Chinese Journal of Nosocomiology

基　　金：海南省卫生健康行业科研基金资助项目(21A200336)。

摘　　要：目的探讨老年前列腺增生(BPH)术后尿路感染危险因素及对转化生长因子-β1(TGF-β1)/Smads信号通路的影响。方法回顾性分析2018年9月-2020年9月在海南省第二人民医院行经尿道前列腺电切(TURP)术治疗的108例老年BPH患者一般临床资料,根据患者是否出现术后尿路感染分为感染组22例、非感染组86例,分析病原菌分布、感染危险因素及预后情况,检测两组患者外周血TGF-β1/Smads信号通路相关指标及炎性因子。结果22例患者标本中分离出24株病原菌,主要包含粪肠球菌、大肠埃希菌;多因素分析显示术前尿潴留导尿、手术时间是术后尿路感染的危险因素(P<0.05);感染组TGF-β1、Smad4、白细胞介素-1β(IL-1β)、前列腺素E2(PGE2)、肿瘤坏死因子(TNF-α)高于未感染组,Smad7低于未感染组(P<0.05),且随感染加重,TGF-β1、Smad4、IL-1β、PGE2、TNF-α升高,Smad7降低(P<0.05);合理用药后转归良好。结论TURP术后尿路感染会导致TGF-β1/Smads信号通路改变,可能与血清炎症因子水平升高相关,但通过合理用药及针对性干预,可使预后转归良好。OBJECTIVE To explore the risk factors for postoperative urinary tract infections in elderly patients with benign prostatic hyperplasia(BPH)and observe the influence on transforming growth factor beta 1(TGF-β1)/Smads signaling pathways.METHODS A total of 108 elderly patients with BPH who underwent transurethral resection of prostate(TURP)in Hainan Second People's Hospital from Sep 2018 to Sep 2020 were enrolled in the study and were divided into the infection group with 22 cases and the non-infection group with 86 cases according to the status of postoperative urinary tract infections,and the baseline clinical data of the enrolled patients were retrospectively analyzed.The distribution of pathogens,risk factors for the infections and treatment outcomes were analyzed.The peripheral blood TGF-β1/Smads signaling pathway-related indexes and inflammatory factors were detected for the two groups of patients.RESULTS Totally 24 strains of pathogens were isolated from specimens of 22 patients,among which Enterococcus faecalis and Enterococcus coli were dominant.Multivariate analysis showed that preoperative urinary retention and operation duration were the risk factors for the postoperative urinary tract infections(P<0.05).The TGF-βl,Smad4,interleukin-1β(IL-1β),prostaglandin E2(PGE2)and tumor necrosis factor-α(TNF-α)of the infection group were significantly higher than those of the non-infection group,while the Smad7 of the infection group was significantly lower than that of the non-infection group(P<0.05);the TGF-β1,Smad4,IL-1β,PGE2 and TNF-αwere significantly elevated with the aggravation of infections,and the Smad7 was significantly reduced(P<0.05).The treatment outcomes were favorable after the reasonable drug administration.CONCLUSION The postoperative urinary tract infections may lead to the changes of TGF-β1/Smads signaling pathways of the TURP patients,which may be associated with the rise of serum inflammatory factors.Reasonable use of drugs and targeted interventions can facilitate favorable treatment

关 键 词：经尿道前列腺电切 前列腺增生 尿路感染 病原菌 危险因素 转化生长因子-β1/Smads信号通路 预后转归 

分 类 号：R697.3[医药卫生—泌尿科学]