摘要
目的分析老年冠心病患者经皮冠状动脉介入治疗(PCI)术后感染与CYP2C19基因多态性的相关性.方法随机选取平度市人民医院于2017年4月-2019年4月收治的老年冠心病PCI手术治疗后患者192例,另选取自愿参加研究的健康人群96名为对照组,将患者术后感染情况分为研究组(感染者)107例及未感染组(非感染者)85例.观察三组研究对象白细胞介素-10(IL-10)、IL-6、肿瘤坏死因子(TNF-α),比较研究组及未感染组并发症发生率以及感染病原菌,CYP2C19基因型.使用Logistic回归分析术后感染患者的危险因素.结果PCI术后感染共培养分离病原菌107株,其中革兰阴性菌51株占47.66%,革兰阳性菌31株占28.97%,真菌25株占23.36%,以铜绿假单胞菌、金黄色葡萄球菌为主.研究组患者IL-10、IL-6与TNF-α分别为(143.96±22.89)pg/ml、(13.46±3.08)pg/ml与(2.87±0.66)ng/ml高于未感染组、对照组(P<0.05).研究组CYP2C19基因快代谢型及慢代谢型分别为14.02%、85.98%与未感染组比较差异有统计学意义(P<0.05).Logistic多因素回归分析结果显示,CYP2C19弱基因型与患者出现术后感染有关(P<0.05).两组并发症发生率差异有统计学意义(P=0.024).结论CYP2C19基因多态性与老年冠心病患者PCI术后感染有密切关系.同时应当注意对患者革兰阴性菌、阳性菌的抗感染治疗,避免患者发生感染情况,影响整体治疗效果与恢复效果.
OBJECTIVE To analyze the correlation between infection and polymorphisms of CYP2 C19 gene in elderly patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).METHODS A total of 192 elderly CHD patients after PCI admitted to the Pingdu People’s Hospital from Apr.2017 to Apr.2019 were randomly selected,another 96 healthy controls who volunteered to participate in the study were selected as control group.According to presence or absence of postoperative infection,they were divided into 107 cases of study group(infection)and 85 cases of non-infection group(non-infection).The levels of interleukin-10(IL-10),IL-6 and tumor necrosis factor-α(TNF-α)in the three groups were observed.The incidence of complications,pathogens and CYP2 C19 genotypes were compared between study group and non-infection group.The risk factors of postoperative infection were analyzed by Logistic regression analysis.RESULTS A total of 107 strains of pathogens were co-cultured and isolated after PCI,of which 51 strains of Gram-negative bacteria accounted for 47.66%,31 strains of Gram-positive bacteria accounted for 28.97%and 25 strains of fungi accounted for 23.36%,dominating by Pseudomonas aeruginosa and Staphylococcus aureus.The levels of IL-10,IL-6 and TNF-αin study group were(143.96±22.89)pg/ml,(13.46±3.08)pg/ml and(2.87±0.66)ng/ml,respectively,significantly higher than those in non-infection group and control group(P<0.05).In study group,the fast metabolism and slow metabolism types of CYP2 C19 gene were 14.02%and 85.98%,respectively,and the differences were significant compared with those in non-infection group(P<0.05).Logistic multivariate regression analysis showed that weak genotype of CYP2 C19 was related with postoperative infection(P<0.05).The differences in the complication rate between the two groups was significant(P=0.024).CONCLUSION The polymorphisms of CYP2 C19 gene were closely related to infection in elderly CHD patients after PCI.At the same time,attention should be paid to the anti-infecti
作者
卢永艳
杜翠娴
李晓君
刘娟
孙晓花
LU Yong-yan;DU Cui-xian;LI Xiao-jun;LIU Juan;SUN Xiao-hua(Pingdu People's Hospital,Qingdao,Shandong 266700,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第10期1547-1551,共5页
Chinese Journal of Nosocomiology
基金
山东省自然科学基金资助项目(ZR2014HL077)。
