OLFM4、CTSC、LL-37及PCT联合检测在外伤或手术患者细菌感染早期诊断的价值研究  

Study on the value of OLFM4,CTSC,LL-37 and PCT combined detection in the early diagnosis of bacterial infection in patients with trauma or surgery

作　　者：胡恒贵[1] 杜晓雷 许元元[1] HU Henggui;DU Xiaolei;XU Yuanyuan(Department of Clinical Laboratory,Wanbei Coal-Electricity Group General Hospital,Suzhou,Anhui 234000,China)

机构地区：[1]皖北煤电集团总医院检验科,安徽宿州234000

出　　处：《国际检验医学杂志》2025年第4期430-434,共5页International Journal of Laboratory Medicine

基　　金：宿州市科技局科研课题计划项目(SZSKJJZC042)。

摘　　要：目的探讨嗅素结构域家族蛋白4(OLFM4)、组织蛋白酶C(CTSC)、LL-37及降钙素原(PCT)联合检测在外伤或手术患者细菌感染早期诊断的价值。方法选取2023年1—7月该院收治住院的外伤或手术160例患者进行血培养或分泌物培养,根据细菌培养结果分为细菌培养阳性患者(阳性组)120例,细菌培养阴性患者(阴性组)40例。阳性组根据病原菌类型分为53例革兰阴性菌感染组(G-菌组)和67例革兰阳性菌感染组(G+菌组)。另选取同期该院体检健康者30例作为对照组。比较各组及阳性组敏感菌和耐药菌患者血清OLFM4、CTSC、LL-37和PCT水平,以及中性粒细胞OLFM4、CTSC和LL-37 mRNA相对表达水平。结果阴性组和阳性组血清OLFM4、CTSC、LL-37和PCT水平显著高于对照组,差异有统计学意义(P<0.05)。阴性组和阳性组OLFM4、CTSC和LL-37 mRNA相对表达水平显著高于对照组,差异有统计学意义(P<0.05)。G-菌组血清PCT水平显著高于G+菌组,差异有统计学意义(P<0.05)。敏感菌患者血清CTSC和LL-37水平显著高于耐药菌患者,耐药菌患者血清OLFM4水平显著高于敏感菌患者,差异有统计学意义(P<0.05)。敏感菌患者中性粒细胞CTSC mRNA和LL-37 mRNA相对表达水平显著高于耐药菌患者,差异有统计学意义(P<0.05)。结论PCT可作为外伤或手术患者细菌感染的早期诊断评估指标,OLFM4和LL-37指标能较好地区分敏感菌与耐药菌感染及疗效预后判断。Objective To investigate the value of olfactomedin domain family 4(OLFM4),cathepsin C(CTSC),LL-37 and procalcitonin(PCT)combined detection in the early diagnosis of bacterial infection in patients with trauma or surgery.Methods A total of 160 patients with trauma or surgery admitted to a hospital from January to July 2023 were selected for blood culture or secretion culture.According to the results of bacterial culture,120 patients with positive bacterial culture were selected as positive group and 40 patients with negative bacterial culture were selected as negative group.The positive group was divided into 53 Gram-negative bacteria infection group(G-bacteria group)and 67 Gram-positive bacteria infection group(G+bacteria group)according to the types of pathogens.Another 30 healthy subjects in a hospital during the same period were selected as the control group.The serum levels of OLFM4,CTSC,LL-37 and PCT,and the relative mRNA expression levels of OLFM4,CTSC and LL-37 in neutrophils were compared among all groups and positive groups.Results Serum levels of OLFM4,CTSC,LL-37 and PCT in negative and positive groups were significantly higher than those in control group,with statistical significance(P<0.05).The relative expression levels of OLFM4,CTSC and LL-37 mRNA in negative and positive groups were significantly higher than those in control group,with statistical significance(P<0.05).The serum PCT level of G-bacteria group was significantly higher than that of G+bacteria group,and the differences was statistically significant(P<0.05).The serum levels of CTSC and LL-37 in patients with sensitive bacteria were significantly higher than those in patients with drug-resistant bacteria,and the serum levels of OLFM4 in patients with drug-resistant bacteria were significantly higher than those in patients with sensitive bacteria,with statistical significance(P<0.05).The relative expression levels of CTSC mRNA and LL-37 mRNA in neutrophils in patients with sensitive bacteria were significantly higher than those in patients

关 键 词：降钙素原 嗅素结构域家族蛋白4 组织蛋白酶C LL-37 

分 类 号：R446.5[医药卫生—诊断学]