摘要
目的探究维持性血液透析并发感染患者外周血微小RNA 155(miR-155)、辅助性T细胞17(Th17细胞)及白细胞介素-17(IL-17)的表达水平及临床意义。方法选取2018年1月-2020年6月吉安市中心人民医院肾内科进行维持性血液透析患者153例,按照是否并发医院感染分为感染组58例和未感染组95例,统计并发感染患者病原菌分布情况,采用荧光定量聚合酶链式反应(PCR)法检测外周血miR-155表达,流式细胞仪检测外周血Th17细胞比例,酶联免疫吸附法检测血清Th17细胞相关因子IL-17和IL-23的含量。结果感染组患者外周血miR-155、Th17细胞比例、IL-17及IL-23水平均高于未感染组(P<0.001);上述指标对于患者并发感染的AUC分别为0.755(95%CI为0.671~0.839)、0.742(95%CI为0.660~0.823)、0.728(95%CI为0.645~0.811)、0.773(95%CI为0.695~0.850);共培养分离病原菌94株,其中革兰阴性菌59株占62.77%,革兰阳性菌25株占26.60%,真菌10株占10.64%,以大肠埃希菌、铜绿假单胞菌、鲍氏不动杆菌为主;感染组患者以细菌感染为主,占72.41%(42/58),不同感染类型患者外周血miR-155、Th17细胞比例、IL-17及IL-23,差异无统计学意义。结论维持性血液透析并发感染患者外周血miR-155、Th17细胞比例、IL-17及IL-23水平升高,上述指标对于患者并发医院感染具有一定的诊断价值。
OBJECTIVE To explore the expression levels and clinical significance of microRNA 155(miR-155),helper T cells 17(Th17 cells)and interleukin 17(IL-17)in peripheral blood of infection patients undergoing maintenance hemodialysis(MHD).METHODS A total of 153 patients undergoing MHD in the Nephrology Department of Ji’an Central People’s Hospital from Jan.2018 to Jun.2020 were enrolled.According to presence or absence of nosocomial infection,they were divided into the infection group(58 cases)and non-infection group(95 cases).The distribution of pathogens in two groups was statistically analyzed.The expression of peripheral blood miR-155 was detected by fluorescence quantitative PCR assay.The ratio of peripheral blood Th17 cells was detected by flow cytometry.The contents of serum Th17 cells related factors,such as IL-17 and IL-23,were detected by enzyme-linked immunosorbent assay.RESULTS The ratios of peripheral blood miR-155,Th17 cells,IL-17 and IL-23 levels in the infection group were significantly higher than those in the non-infection group(P<0.001).AUC values of the above indexes for predicting infection were 0.755(95%CI:0.671-0.839),0.742(95%CI:0.660-0.823),0.728(95%CI:0.645-0.811)and 0.773(95%CI:0.695-0.850),respectively.There were 94 strains of pathogens were isolated by co-culture assay,including 59 strains(62.77%)of Gram-negative bacteria,25 strains(26.60%)of Gram-positive bacteria and 10 strains(10.64%)of fungi,mainly on Escherichia coli,Pseudomonas aeruginosa and Acinetobacter baumannii.The patients with bacterial infection were in the moajority in infection group[72.41%(42/58)].There was no significant difference in ratios of peripheral blood miR-155 and Th17 cells,levels of IL-17 and IL-23 among patients with different types of infection.CONCLUSION The ratios of peripheral blood miR-155 and Th17 cells and levels of IL-17 and IL-23 are increased in infection patients undergoing MHD.The above indexes are of certain diagnostic value for nosocomial infection.
作者
刘金平
解长飞
LIU Jin-ping;XIE Chang-fei(Ji′an Central People′s Hospital,Ji′an,Jiangxi 343000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第12期1846-1850,共5页
Chinese Journal of Nosocomiology
基金
江西省科研基金资助项目(201921512)。
