输尿管结石术后并发泌尿系统感染血清LPS、Caspase9、ESM-1表达及其预测价值  

Expressions of serum LPS,Caspase 9 and ESM-1 in ureteral calculi patients complicated with postoperative urinary tract infection and their predictive values

作　　者：陈超[1] 孙涛 杨礼宾 王强辉 CHEN Chao;SUN Tao;YANG Li-bin;WANG Qiang-hui(Ningbo Municipal Hospital of Traditional Chinese Medicine(TCM),Af filiated Hospital of Zhejiang Chinese Medical University,Ningbo,Zhejiang 315016,China)

机构地区：[1]浙江中医药大学附属宁波市中医院泌尿外科,浙江宁波315016

出　　处：《中华医院感染学杂志》2024年第21期3306-3310,共5页Chinese Journal of Nosocomiology

基　　金：浙江省卫生健康科技计划项目(2022RC250)。

摘　　要：目的探究输尿管结石(UC)术后并发泌尿系统感染血清脂多糖(LPS)、半胱氨酸天冬氨酸蛋白酶9(Caspase 9)、内皮细胞特异性分子-1(ESM-1)表达及其预测价值。方法选取宁波市中医院2021年4月-2023年6月收治的UC术后并发泌尿系统感染患者72例为感染组,另用简单随机化法选取同期收治的UC术后未并发泌尿系统感染患者75例为非感染组。统计UC术后并发泌尿系统感染的病原学特征及耐药情况;比较两组血清LPS、Caspase 9、ESM-1水平,采用受试者工作特征(ROC)曲线分析LPS、Caspase 9、ESM-1对UC术后并发泌尿系统感染的预测价值。结果感染组检出的81株病原菌中革兰阴性菌占比最高,以大肠埃希菌为主,革兰阳性菌以粪肠球菌为主。大肠埃希菌对头孢唑林、氨苄西林耐药严重,对亚胺培南、厄他培南、呋喃妥因较敏感;粪肠球菌对克林霉素耐药严重,对呋喃妥因、利奈唑胺、替加环素、万古霉素较敏感。感染组血清LPS、Caspase 9、ESM-1水平高于非感染组(P<0.05)。LPS、Caspase 9、ESM-1联合检测诊断UC术后并发泌尿系统感染的曲线下面积(AUC)值高于各指标单一检测(P<0.05)。结论革兰阴性菌是UC患者术后并发泌尿系统感染的主要病原菌,根据耐药性结果选择合理的抗菌药物,LPS、Caspase 9、ESM-1可用来诊断UC患者术后并发泌尿系统感染。OBJECTIVE To explore the expressions of serum lipopolysaccharide(LPS),cysteine aspartic protease 9(Caspase 9)and endothelial cell specific molecular 1(ESM-1)in the ureteral calculi(UC)patients complicated with postoperative urinary tract infection and analyze the predictive values.METHODS A total of 72 UC patients complicated with postoperative urinary tract infection who were treated in Ningbo Hospital of Traditional Chinese Medicine from Apr.2021 to Jun.2023 were assigned as the infection group,meanwhile,75 UC patients who were not complicated with postoperative urinary tract infection were randomly chosen as the non-infection group.The etiological characteristics of the postoperative urinary tract infection and drug resistance rates were statistically analyzed.The levels of serum LPS,Caspase 9 and ESM-1 were compared between the two groups.The values of LPS,Caspase 9 and ESM-1 in prediction of postoperative urinary tract infection in the UC patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Totally 81 strains of pathogens were isolated from the infection group,among which gram-negative bacteria were dominant,and Escherichia coli was the predominant species;Enterococcus faecalis was dominant among the gram-positive bacteria.The E.coli strains were highly resistant to cefazolin and ampicillin but were sensitive to imipenem,ertapenem and nitrofurantoin.The E.faecalis strains were highly resistant to clindamycin but were sensitive to nitrofurantoin,linezolid,tigecycline and vancomycin.The levels of serum LPS,Caspase 9 and ESM-1 of the infection group were significantly higher than those of the non-infection group(P<0.05).The area under the curve(AUC)of the joint detection of LPS,Caspase 9 and ESM-1 was significantly higher than that of the single detection in diagnosis of the postoperative urinary tract infection in the UC patients(P<0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated form the UC patients complicated with postoperative urinary

关 键 词：输尿管结石 感染 病原菌 大肠埃希菌 耐药性 脂多糖 半胱氨酸天冬氨酸蛋白酶9 内皮细胞特异性分子-1 受试者工作特征曲线 诊断价值 

分 类 号：R693.4[医药卫生—泌尿科学]