慢性肾小球肾炎血液透析导管相关性感染影响因素及血清miRNA-15a、miRNA-21表达  

Influencing factors for catheter-related infection in chronic glomerulonephritis patients undergoing hemodialysis and expressions of serum miRNA-15a and miRNA-21

作　　者：陈瑶 王晓萍 李云美 周鑫 朱亚华 CHEN Yao;WANG Xiao-ping;LI Yun-mei;ZHOU Xin;ZHU Ya-hua(Graduate School of Nursing,Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310020,China;不详)

机构地区：[1]浙江中医药大学护理学院,浙江杭州310020 [2]浙江大学附属邵逸夫医院血透室,浙江杭州310016

出　　处：《中华医院感染学杂志》2024年第13期1969-1973,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2020KY712);杭州市医药卫生科技项目一般基金资助项目(A20230691)。

摘　　要：目的探究慢性肾小球肾炎血液透析患者导管相关性感染影响因素及与血清miRNA-15a、miRNA-21表达。方法以2021年6月-2023年6月于浙江大学附属邵逸夫医院就诊的97例慢性肾小球肾炎血液透析患者为研究对象,检测导管相关性感染患者病原菌分布,分析血清miRNA-15a、miRNA-21表达对感染的评估价值及慢性肾小球肾炎血液透析出现导管相关感染的影响因素。结果慢性肾小球肾炎患者导管相关性感染率为19.59%,其中包括血流感染14例、局部感染5例。19例导管相关性感染患者共检出病原菌19株,其中革兰阳性菌检出率最高。感染组血清miRNA-15a水平低于未感染组,miRNA-21水平高于未感染组(P<0.05)。受试者工作特性(ROC)曲线分析显示,血清指标联合检测诊断血液透析患者导管相关性感染的曲线下面积(AUC)大于血清miRNA-15a水平单独检测(P<0.05)。置管部位为股内静脉、miRNA-21≥0.82为血液透析患者导管相关性感染的影响因素(P<0.05)。结论血清miRNA-21表达异常变化及置管部位为股内静脉是慢性肾小球肾炎血液透析患者导管相关性感染的影响因素,且血清miRNA-15a、、miRNA-21水平联合检测对感染具诊断价值。OBJECTIVE To explore the influencing factors for catheter-related infection in the chronic glomerulone-phritis patients undergoing hemodialysis and analyze the expressions of serum miRNA-15a and miRNA-21.METHODS A total of 97 patients with chronic glomerulonephritis who underwent hemodialysis in Sir Run Run Shaw Hospital Affiliated to Zhejiang University from Jun 2021 to Jun 2023 were recruited as the research subjects.The distribution of pathogens isolated from the patients with catheter-related infection was observed.The value of serum miRNA-15a and miRNA-21 in assessment of the infection and the influencing factors for the catheter-relat-ed infection were analyzed.RESULTS The incidence rate of catheter-related infection was 19.59%among the chro-nic glomerulonephritis patients,and there were 14 cases of bloodstream infection and 5 cases of local infection.To-tally 19 strains of pathogens were isolated from the 19 patients with catheter-related infection,and the isolation rate of gram-positive bacteria was the highest.The serum miRNA-15a level of the infection group was significantly lower than that of the no infection group,while the miRNA-21 of the infection group was significantly higher than that of the no infection group(P<0.05).The receiver operating characteristic(ROC)curve showed that the area under curve(AUC)of the joint detection of the serum indexes was significantly higher than that of the single detection of serum miRNA-15a in diagnosis of the catheter-related infection in the hemodialysis patients(P<0.05).Femoral venous catheterization and miRNA-21 no less than 0.82 were the influencing factors for the catheter-related infection(P<0.05).CONCLUSION The abnormal expression of serum miRNA-21 and femoral venous catheterization are the influencing factors for the catheter-related infection in the chronic glomerulonephritis patients undergoing hemodialysis.The joint detection of serum miRNA-15a and miRNA-21 has value in diagnosis of the infection.

关 键 词：慢性肾小球肾炎 血液透析 导管相关性感染 影响因素 微小RNA-15a 微小RNA-21 

分 类 号：R692.3[医药卫生—泌尿科学]