肛周脓肿患者病原菌分布及其血清TGF-β、MMP-2、EGF、ACTA水平的临床意义  

Pathogenic bacteria isolated from patients with perianal abscess and clinical significance of serum TGF-β,MMP-2,EGF and ACTA

作　　者：柯红娟 汪昭民 江艳 李昂 汪伟 KE Hong-juan;WANG Zhao-min;JIANG Yan;LI Ang;WANG Wei(Wuhan Eighth Hospital,Wuhan,Hubei 430000,China;不详)

机构地区：[1]武汉市第八医院肛肠疾病诊疗中心二病区,湖北武汉430000 [2]鄂州市中医医院肛肠科,湖北鄂州436000

出　　处：《中华医院感染学杂志》2025年第1期55-59,共5页Chinese Journal of Nosocomiology

基　　金：湖北省卫生健康委员会项目(2022LK03511)。

摘　　要：目的分析肛周脓肿患者病原菌分布及血清转化生长因子-β(TGF-β)、基质金属蛋白酶-2(MMP-2)、表皮生长因子(EGF)、激活素A(ACTA)水平。方法选取2021年8月-2023年8月武汉市第八医院收治的肛周脓肿患者577例为研究组,另选取同期健康体检者619名为对照组,统计肛周脓肿患者病原菌分布,比较两组血清TGF-β、MMP-2、EGF、ACTA与肛门功能指标水平及其相关性。结果577例肛周脓肿患者共分离595株病原菌,革兰阴性菌(66.22%)、革兰阳性菌(28.74%),主要种类为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、草绿色链球菌,真菌(5.04%)均为白假丝酵母;研究组血清TGF-β、EGF水平及肛管最大收缩压、肛管静息压、直肠静息压低于对照组,血清MMP-2、ACTA水平高于对照组(P<0.05);肛周脓肿患者血清TGF-β、EGF与肛管最大收缩压、肛管静息压、直肠静息压呈正相关(P<0.05),血清MMP-2、ACTA与肛管最大收缩压、肛管静息压、直肠静息压呈负相关(P<0.05)。结论肛周脓肿患者主要感染病原菌为革兰阴性菌,其可导致血清TGF-β、MMP-2、EGF、ACTA水平及肛门功能异常,且血清指标变化与肛门功能恢复密切相关。OBJECTIVE To investigate the distribution of pathogens isolated from the patients with perianal abscess and observe the levels of serum transforming growth factor-β(TGF-β),matrix metalloproteinase-2(MMP-2),epidermal growth factor(EGF)and activin A(ACTA).METHODS A total of 577 patients with perianal abscess who were treated in Wuhan Eighth Hospital from Aug.2021 to Aug.2023 were assigned as the study group,meanwhile,619 healthy people who received physical examination were chosen as the control group.The distribution of pathogens isolated from the patients with perianal abscess was statistically analyzed.The levels of serum TGF-β,MMP-2,EGF,ACTA and anal function indexes were observed and compared between the two groups,and the association was analyzed.RESULTS Totally 595 strains of pathogens were isolated from the 577 patients with perianal abscess,66.22%of which were gram-negative bacteria,28.74%were gram-positive bacteria,and 5.04%were fungi.Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus and Streptococcus viridans were the major species of pathogens.All of the fungi were Candida albicans.The serum TGF-βlevel,EGF level,maximal systolic pressure of anal canal,resting pressure of anal canal and resting pressure of rectum were lower in the study group than in the control group,while the levels of serum MMP-2 and ACTA of the study group were higher than those of the control group(P<O.05).The serum TGF-βand EGF were positively correlated with the maximal systolic pressure of anal canal,resting pressure of anal canal and resting pressure of rectum(P<0.05);the serum MMP-2 and ACTA were negatively correlated with the maximal systolic pressure of anal canal,resting pressure of anal canal and resting pressure of rectum(P<0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the patients with perianal abscess and may lead to the abnormal changes of serum TGF-β,MMP-2,EGF,ACTA and anal function indexes.The change of serologic indexes is closely associated with the reco

关 键 词：肛周脓肿 感染 病原菌 转化生长因子-Β 基质金属蛋白酶-2 表皮生长因子 激活素A 

分 类 号：R657.15[医药卫生—外科学]