开放性骨折患者术后切口感染病原菌及血清MCP-1、bFGF、miR-223的预测价值  

Distribution of pathogens isolated from open fracture patients with postoperative incision infection and predictive values of serum MCP-1,bFGF and miR-223

作　　者：陈余兴 王贵 黎尊成 CHEN Yu-xing;WANG Gui;LI Zun-cheng(Hainan West Central Hospital,Danzhou,Hainan 571700,China)

机构地区：[1]海南西部中心医院骨科,海南詹州571700

出　　处：《中华医院感染学杂志》2024年第9期1374-1378,共5页Chinese Journal of Nosocomiology

基　　金：海南省卫生健康委基金项目(20A200368)。

摘　　要：目的探究开放性骨折患者术后切口感染病原菌分布及血清单核细胞趋化蛋白-1(MCP-1)、碱性成纤维细胞生长因子(bFGF)、微小RNA(miR)-223的预测价值。方法选取2020年1月-2023年1月海南西部中心医院96例开放性骨折术后发生切口感染患者为研究组,同期开放性骨折术后未发生切口感染患者96例为对照组,分析开放性骨折患者术后切口感染病原菌分布,多因素Logistic回归分析术后切口感染的危险因素,受试者工作特征(ROC)曲线分析MCP-1、bFGF、miR-223对术后切口感染的诊断价值。结果96例开放性骨折术后切口感染患者共培养出96株病原菌,其中革兰阳性菌52株(54.17%),革兰阴性菌40株(41.67%),真菌4株(4.17%);年龄>60岁、伤后到院时间≥6 h、手术时间≥3 h、伤口深度≥2 cm、住院时间≥4周、糖尿病、手术切口Ⅱ-Ⅲ类及CRP水平高均为术后切口感染的危险因素;与对照组比较,研究组MCP-1、miR-223水平升高(P<0.05),bFGF水平降低(P<0.05),ROC曲线结果显示,三者联合诊断术后切口感染的曲线下面积(AUC)为0.926。结论开放性骨折患者术后切口感染以金黄色葡萄球菌、表皮葡萄球菌、大肠埃希菌、铜绿假单胞菌为主,诸多因素导致术后切口感染,且感染后MCP-1、miR-223水平升高,bFGF水平降低,三者联合检测诊断价值较高。OBJECTIVE To explore he distribution of pathogens isolated from the open fracture patients with postoperative incision infection and analyze the predictive values of serum monocyte chemoattractant protein(MCP-1),basic fibroblast growth factor(bFGF)and micro ribonucleic acid(miR)-223.METHODS A total of 96 open fracture patients who had postoperative incision infection in Hainan West Central Hospital from Jan 2020 to Jan 2023 were assigned as the study group,meanwhile,96 open fracture patients who did not have postoperative incision infection were chosen as the control group.The distribution of pathogens isolated from the open fracture patients with postoperative incision infection was observed,multivariate logistic regression analysis was performed for the risk factors for the postoperative incision infection,and the values of MCP-1,bFGF and miR-223 in diagnosis of postoperative incision infection were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Totally 96 strains of pathogens were isolated from the 96 open fracture patients with postoperative incision infection,52(54.17%)of which were gram-positive bacteria,40(41.67%)were gram-negative bacteria,and 4(4.17%)were fungi.The more than 60 years of age,interval between injury and admission no less than 6 hours,operation duration no less than 3 hours,depth of wound no less than 2 cm,length of hospital stay no less than 4 weeks,diabetes mellitus,type II-III incision surgery and high level of CRP were the risk factors for the postoperative incision infection.The levels of MCP-1 and miR-223 of the study group were significantly higher than those of the control group(P<0.05),the bFGF level of the study group was significantly lower than that of the control group(P<0.05).The result of ROC curve analysis showed that the area under curve(AUC)of the joint detection of the three indexes was 0.926 in diagnosis of the postoperative incision infection.CONCLUSION Staphylococcus aureus,Staphylococcus epidermidis,Escherichia coli and Pseudomonas aeruginos

关 键 词：开放性骨折 切口感染 病原菌 单核细胞趋化蛋白-1 碱性成纤维细胞生长因子 微小RNA-223 风险因素 受试者工作特征曲线 

分 类 号：R687.3[医药卫生—骨科学]