类风湿关节炎合并感染病原菌和血清SiCAM、CXCL10、IL-17表达及其诊断价值  

Pathogens and expressions of serum SiCAM,CXCL10 and IL-17 in rheumatoid arthritis patients complicated with infection and their diagnostic values

作　　者：刘晓光 宋薇 刘静 LIU Xiao-guang;SONG Wei;LIU Jing(Weihai Medical Area,970 Hospital of The Joint Logistics Support Force of The People's Liberation Army of China,Weihai,Shandong 264200,China)

机构地区：[1]解放军联勤保障部队第九七〇医院威海医疗区风湿科,山东威海264200 [2]解放军联勤保障部队第九七〇医院肿瘤血液病区,山东威海264200

出　　处：《中华医院感染学杂志》2024年第21期3251-3255,共5页Chinese Journal of Nosocomiology

基　　金：山东省卫生健康委员会基金资助项目(2021LK0341)。

摘　　要：目的探讨类风湿关节炎合并感染病原菌和血清可溶性细胞间黏附分子(SiCAM)、趋化因子C-X-C配体10(CXCL10)、白细胞介素(IL)-17表达及其诊断价值。方法选取2019年7月-2023年7月解放军联勤保障部队第970医院收治的62例类风湿关节炎合并感染患者为感染组和66例类风湿关节炎未发生感染患者为非感染组,分析病原菌分布特点及耐药性,比较两组血清SiCAM、CXCL10、IL-17表达,分析血清SiCAM、CXCL10、IL-17单独及联合检测对类风湿关节炎患者合并感染的诊断价值。结果62例类风湿关节炎合并感染患者共培养出78株病原菌,主要为大肠埃希菌和金黄色葡萄球菌。大肠埃希菌对氨苄西林耐药严重,金黄色葡萄球菌对青霉素耐药严重。感染组血清SiCAM、CXCL10、IL-17表达高于非感染组(P<0.05)。血清SiCAM、CXCL10、IL-17指标联合检测对类风湿关节炎合并感染患者的诊断曲线下面积(AUC)值高于单独检测(P<0.05),且联合检测的敏感度为88.71%,特异度为90.91%。结论类风湿关节炎合并感染患者主要病原菌为大肠埃希菌和金黄色葡萄球菌,大肠埃希菌对氨苄西林耐药严重,金黄色葡萄球菌对青霉素耐药严重。类风湿关节炎合并感染患者血清SiCAM、CXCL10、IL-17呈高表达,且三指标联合检测对类风湿关节炎合并感染诊断价值高。OBJECTIVE To explore the pathogens isolated from the rheumatoid arthritis(RA)patients complicated with infection,observe the expressions of serum soluble intercellular adhesion molecule(SiCAM),chemokine C-X-C ligand 10(CXCL10)and interleukin(IL)-17,and analyze the diagnostic values.METHODS A total of 62 RA patients complicated with infection and 66 RA patients without infection who were treated in 970 Hospital of the Joint Logistics Support Force of the People′s Liberation Army of China from Jul.2019 to Jul.2023 were enrolled in the study and were respectively assigned as the infection group and the non-infection group.The distribution and drug resistance of the pathogens were analyzed,the expression levels of serum SiCAM,CXCL10 and IL-17 were compared between the two groups.The values of the single and joint detection of serum SiCAM,CXCL10 and IL-17 in diagnosis of the infection were analyzed.RESULTS Totally 78 strains of pathogens were isolated from the 62 RA patients complicated with infection;Escherichia coli and Staphylococcus aureus were the predominant species of pathogens.The E.coli strains were highly resistant to ampicillin,and the S.aureus strains were highly resistant to penicillin.The expression levels of serum SiCAM,CXCL10 and IL-17 of the infection group were higher than those of the non-infection group(P<0.05).The area under the curve(AUC)of the joint detection of serum SiCAM,CXCL10 and IL-17 was higher than that of the single detection in diagnosis of the infection in the RA patients(P<0.05),the sensitivity of the joint detection was 88.71%,with the specificity 90.91%.CONCLUSIONS The E.coli and S.aureus are the predominant species of pathogens isolated from the RA patients complicated with infection.The E.coli strains are highly resistant to ampicillin,and the S.aureus strains are highly resistant to penicillin.The RA patients complicated with infection show the high expressions of serum SiCAM,CXCL10 and IL-17.The joint detection of the three indexes has high value in diagnosis of the infection

关 键 词：类风湿关节炎 感染 病原菌 耐药性 可溶性细胞间黏附分子 趋化因子C-X-C配体10 白细胞介素-17 诊断价值 

分 类 号：R593.22[医药卫生—内科学]