摘要
目的探讨急性脑梗死（ACI）合并肺部感染患者病原菌分布及对凋亡蛋白表达的影响。方法回顾性分析2014年1月至2017年10月武警后勤学院附属医院脑科中心收治的178例ACI患者的临床资料，86例ACI合并肺部感染患者作为观察组，92例无肺部感染的ACI患者作为对照组。采用法国梅里埃微生物全自动鉴定仪进行病原菌鉴定分型；采用酶联免疫吸附试验（ELISA）检测两组患者血清白细胞介素（IL-8、IL-17）、可溶性细胞间黏附分子-1（sICAM-1）及B淋巴细胞瘤-2相关X蛋白（Bax）、B淋巴细胞瘤-2蛋白（Bcl-2）含量；采用Pearson相关分析法分析观察组sICAM-1与Bax、Bcl-2蛋白表达的相关性。结果86例ACI合并肺部感染患者共培养分离出病原菌86株，其中革兰阳性（G＋）菌41株（占47．67％），主要为金黄色葡萄球菌（占25．58％）；革兰阴性（G-）菌37株（占43．02％），主要为鲍曼不动杆菌（占11．63％）；真菌8株（占9．30％）。观察组血清IL-8（μg/L：0．72±0．15比0．68±0．09）、IL-17（μg／L：9．31±3．58比8．12±2．76）、sICAM-1（ng／L：421．36±39．74比385．13±28．59）、Bax（μg／L：4．52±0．47比3．86±0．34）水平均明显高于对照组，Bcl-2水平明显低于对照组（μg／L：0．84±0．26比1．13±0．31），差异均有统计学意义（均P〈0．05）；观察组sICAM-1与Bax呈显著正相关（r=O．401，P〈0．001），与Bcl-2呈显著负相关（r=-0．447，P〈0．001）。结论ACI合并肺部感染患者病原菌以G＋菌为主，感染可引起患者血清促炎因子及sICAM-1水平升高，其机制可能与Bax含量增加和Bcl-2减少有关。
Objective To investigate pathogenic bacteria distribution and its effect on the expression of apoptosis protein in patients with acute cerebral infarction （ACI） complicated with pulmonary infection. Methods A retrospective analysis was conducted. From January 2014 to October 2017, the clinical data of 178 patients suffered from ACI hospitalized in Department of Neuromedical Center of Affiliated Hospital of the Chinese People＇s Armed Police Force Logistics Academy were collected, including 86 cases with ACI complicated with pulmonary infection selected as the observation group, and 92 cases with ACI without pulmonary infection assigned in the control group. The identification and classification of pathogenic bacteria were carried out by using the French BioMienx microorganism fully automatic identification instrument; the contents of serum interleukins （IL-8, IL-17）, soluble inlercellnlar adhesion molecule-1 （sICAM-1） and B type lymphocyte tumor-2 related X protein （Bax）, B lymphocyte tumor-2 protein （Bel-2） in two groups were detected by enzyme-linked immunosorbent assay （ELISA）. Pearson correlation analysis was used to observe the correlations between sICAM-1 and Bax, Bcl-2 protein expression. Results From the bacterial cultures of 86 patients with ACI complicated with pulmonary infection, 86 strains of pathogenic bacteria were isolated, including 41 strains of gram positive （G＋） bacteria （47.67%）, mainly Staphylococcus aureus （25.58%）; 37 strains of gram negative （G-） bacteria （43.02%）, mainly Acinetobacter baumannii （11.63%）; 8 strains of fungi （9.30%）. The serum levels of IL-8 （μg/L： 0.72±0.15 vs. 0.68±0.09）, IL-17 （μg/L： 9.31±3.58 vs. 8.12±2.76）, sICAM-1 （ng/L： 421.36±39.74 vs. 385.13 ± 28.59） and Bax （μg/L： 4.52± 0.47 vs. 3.86 ± 0.34） in the observation group were significantly higher than those in the control group, while the level of Bcl-2 in the observation group was significantly lower than that in the control gro
作者
王鹏
董俊强
薛德友
张赛
孙洪涛
Wang Peng;Dong Junqiang;Xue Deyou;Zhang Sai;Sun Hongtao(Department of Neuromedical Center,Affiliated Hospital of the Chinese People＇s Armed Police Force Logistics Academy,Tianjin 300162,China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2018年第3期250-253,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
国家重点研发计划项目（2016YFC1101500）
关键词
脑梗死
急性
病原菌分布
凋亡
感染
Cerebral infarction
acute
Pathogenic bacteria distribution
Apoptosis
Infection
