重症急性胰腺炎合并腹腔感染病原菌及外周血miRNA、TREM-1基因多态性变化  

Pathogens isolated from severe acute pancreatitis patients complicated with abdominal infection and changes of peripheral blood miRNA and TREM-1 gene polymorphisms

作　　者：李高升[1] 杨彤 赵维波 冯真真 赵梦 LI Gao-sheng;YANG Tong;ZHAO Wei-bo;FENG Zhen-zhen;ZHAO Meng(Gaotang County People's Hospital,Liaocheng,Shandong 252800,China;不详)

机构地区：[1]高唐县人民医院消化内科,山东聊城252800 [2]高唐县人民医院手术室,山东聊城252800 [3]聊城市第二人民医院消化内科,山东聊城252600

出　　处：《中华医院感染学杂志》2024年第21期3266-3270,共5页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(LG2023H135)。

摘　　要：目的探究重症急性胰腺炎(SAP)合并腹腔感染病原菌及外周血微小核糖核酸(miRNA/miR)、髓样细胞表达激发受体-1(TREM-1)基因多态性变化。方法分别将2020年8月-2023年8月高唐县人民医院收治的SAP合并腹腔感染患者75例及随机选择的同期SAP未合并腹腔感染患者82例纳入感染组、非感染组。检测感染组病原菌,比较两组miR-22-3p、miR-21-3p、miR-146a水平及TREM-1基因多态性。受试者工作特征(ROC)曲线分析miR-22-3p、miR-21-3p、miR-146a对SAP合并腹腔感染诊断价值。结果75例感染组患者检出三类病原菌共计87株,大肠埃希菌在革兰阴性菌中占比最高,肠球菌为主要的革兰阳性菌。与非感染组相比,感染组miR-22-3p、miR-21-3p、miR-146a水平升高(P<0.05)。感染组TREM-1 rs2234246位点基因型AA、等位基因A占比高于非感染组(P<0.05),基因型GG、等位基因G占比低于非感染组(P<0.05)。miR-22-3p、miR-21-3p、miR-146a单一检测对SAP合并腹腔感染曲线下面积(AUC)值低于三指标联合检测的AUC值(P<0.05)。结论革兰阴性菌为SAP合并腹腔感染患者主要致病菌,其miR-22-3p、miR-21-3p、miR-146a水平表达异常,且三指标联合检测对其诊断价值高,TREM-1基因多态性可能参与SAP合并腹腔感染病情进展。OBJECTIVE To explore the pathogens isolated from the severe acute pancreatitis(SAP)patients complicated with abdominal infection and observe the changes of peripheral blood micro ribonucleic acid(miRNA/miR)and triggering receptor expressed on myeloid cells-1(TREM-1)gene polymorphisms.METHODS A total of 75 SAP patients who were complicated with abdominal infection and treated in Gaotang County People′s Hospital from Aug.2020 to Aug.2023 were assigned as the infection group,meanwhile,82 SAP patients who were not complicated with abdominal infection were chosen as the non-infection group.The pathogens isolated from the patients of the infection group were identified.The levels of miR-22-3p,miR-21-3p and miR-146a as well as the TREM-1 gene polymorphisms were compared between the two groups.The values of miR-22-3p,miR-21-3p and miR-146a in diagnosis of abdominal infection of the SAP patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Totally 87 strains of pathogens were isolated from the 75 patients of the infection group.Escherichia coli was the predominant species of gram-negative bacteria,and Enterococcus was dominant among gram-positive bacteria.The levels of miR-22-3p,miR-21-3p and miR-146a of the infection group were significantly higher than those of the non-infection group(P<0.05).The percentages of AA genotype and A allele at rs2234246 locus of TREM gene were significantly higher in the infection group than in the non-infection group(P<0.05),while the percentages of GG genotype and G allele were significantly lower in the infection group than in the non-infection group(P<0.05).The area under the curve(AUC)of the single detection of miR-22-3p,miR-21-3p and miR-146a was significantly lower than that of the joint detection of the three indexes in diagnosis of abdominal infection in the SAP patients(P<0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the SAP patients complicated with abdominal infection,the patients show the abnormal

关 键 词：重症急性胰腺炎 腹腔感染 微小核糖核酸 髓样细胞表达激发受体-1 基因多态性 受试者工作特征曲线 预测价值 

分 类 号：R576[医药卫生—消化系统]