老年COPD患者下呼吸道微生物定植与肺部感染的炎症指标及TGFβ1/Smads信号通路  

Inflammatory indicators of microbial colonization of the lower respiratory tract and lung infection in elderly patients with COPD and TGFβ1/Smads signaling pathway

作　　者：余莹 罗琳琳 李洁 焦昕雨 陈照 YU Ying;LUO Lin-lin;LI Jie;JIAO Xin-yu;CHEN Zhao(The Lichuan Ethnic Hospital of Traditional Chinese Medicine,Lichuan,Hubei 445400,China)

机构地区：[1]湖北省利川市民族中医院感控办,湖北利川445400 [2]湖北省利川市民族中医院新生儿科,湖北利川445400 [3]湖北省利川市民族中医院科教科,湖北利川445400

出　　处：《中华医院感染学杂志》2023年第12期1804-1808,共5页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金资助项目(20220536)。

摘　　要：目的 分析老年慢性阻塞性肺疾病(COPD)患者下呼吸道微生物定植与肺部感染的炎症指标及转化生长因子β1/Smads(TGFβ1/Smads)信号通路。方法 选取2021年1-12月湖北省利川市民族中医院老年COPD患者246例,依据是否发生肺部感染分为感染组155例、未感染组91例,按是否存在呼吸道微生物定植分为定植组、未定植组两个亚组,比较各亚组血清降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及肺组织TGFβ1/Smads的表达。结果 155例发生肺部感染,感染率63.01%,检出病原菌304株以革兰阴性菌为主,下呼吸道微生物定植发生率为28.86%(71/246);感染组血清PCT、hs-CRP、IL-8、TNF-α水平高于未感染组(P<0.05);感染组肺组织TGFβ1、Smad2、Smad3水平、下呼吸道微生物定植率均高于未感染组,Smad6、Smad7均低于未感染组(P<0.05);定植组血清PCT、hs-CRP、IL-8、TNF-α及肺部感染率高于未定植组(P<0.05);定植组肺组织TGFβ1、Smad2、Smad3高于未定植组,而Smad6、Smad7均低于未定植组(P<0.05)。结论 老年COPD患者下呼吸道微生物定植与肺部感染有密切关系,其机制可能为通过激活TGFβ1/Smads信号通路,刺激炎症介质释放。OBJECTIVE To analyze the inflammatory indicators of microbial colonization of the lower respiratory tract and lung infection in elderly patients with chronic obstructive pulmonary disease(COPD) and transforming growth factor β1/Smads(TGFβ1/Smads) signaling pathway.METHODS A total of 246 elderly patients with COPD who were admitted to the Lichuan Ethnic Hospital of Traditional Chinese Medicine,Hubei Province from Jan.to Dec.2021 were selected and divided into 155 cases in the infection group and 91 cases in the non-infection group according to the occurrence of lung infection,and into two subgroups,the colonization group and the non-colonization group according to the presence or absence of respiratory microbial colonization.The expression of serum procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),interleukin-8(IL-8) and tumor necrosis factor α(TNF-α) levels,and TGFβ1/Smads expression in lung tissues were compared between groups.RESULTS Totally 155 patients developed pulmonary infection,with an infection rate of 63.01%.304 strains of pathogenic bacteria were detected,mainly gram-negative bacteria,and the incidence of microbial colonization of lower respiratory tract was 28.86%(71/246).Serum PCT,hs-CRP,IL-8 and TNF-α levels in the infection group were higher than those in the non-infection group(P<0.05).The levels of TGFβ1,Smad2 and Smad3 in lung tissues,and incidence of microbial colonization in the infection group were higher than those in the non-infection group,while the levels of Smad6 and Smad7 were lower than those in the non-infection group(P<0.05).Serum PCT,hs-CRP,IL-8 and TNF-α levels,and the incidence of pulmonary infection in the colonization group were higher than those in the non-colonization group(P<0.05).The expression levels of TGFβ1,Smad2 Smad3 in lung tissues of the colonization group were higher than those in the non-colonization group,while the levels of Smad6 and Smad7 were lower than those in the non-colonization group(P<0.05).CONCLUSION Microbial colonization of lower r

关 键 词：老年 慢性阻塞性肺疾病 下呼吸道微生物定植 肺部感染 转化生长因子β1/Smads 信号通路 

分 类 号：R563.1[医药卫生—呼吸系统]