摘要
目的探讨胸部创伤患者早期血清正五聚蛋白(PTX3)、α-黑素细胞刺激素(α-MSH)及CRP水平与创伤后细菌感染的相关性分析。方法选取2017年3月至2019年5月本院收治的96例胸部创伤或以胸部创伤为主的多发伤患者作为创伤组,分为感染组34例和非感染组62例;同期健康体检者100例作为对照组。采用ELISA法检测血清PTX3、α-黑素细胞刺激素(α-MSH)水平;免疫比浊法检测血清CRP水平;ROC曲线评估血清PTX3、α-MSH、CRP水平对胸部创伤并发细菌感染的诊断价值。Logistic回归分析创伤后细菌感染的影响因素。结果创伤组患者血清PTX3、CRP表达水平高于对照组(P<0.05),α-MSH表达水平低于对照组(P<0.05)。创伤组患者血清PTX3、CRP水平入院后1 d内上升,1 d到7 d呈下降趋势,于7 d后低于入院时,创伤组患者血清α-MSH水平入院后1 d内下降,1 d7 d呈上升趋势(P<0.05);感染组胸部创伤患者血清PTX3、CRP水平高于非感染组(P<0.05),α-MSH水平低于非感染组(P<0.05)。血清PTX3、α-MSH、CRP水平联合预测胸部创伤并发细菌感染的ROC曲线下面积、敏感度、特异度、约登指数分别为0.968、88.0%、93.2%、0.820。Logistic多因素回归分析显示PTX3、CRP均是创伤后细菌感染的危险因素(P<0.05),α-MSH是创伤后细菌感染的保护性因素(P<0.05)。结论胸部创伤及创伤后细菌感染发生过程中血清PTX3、CRP水平上升,血清α-MSH水平下降,三者联合检测对胸部创伤并发细菌感染具有一定诊断价值。
Objective To investigate the correlation between early level of serum pentraxin(PTX3)and post-traumatic bacterial infection in patients with chest trauma.Methods Ninety-six patients with chest trauma or multiple trauma mainly caused by chest trauma(trauma group)from March 2017 to May 2019 were selected and divided into infection group(34 cases)or non-infection group(62 cases),with 100 healthy subjects during the same period(control group)as controls.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum PTX3 andα-melanocyte stimulating hormone(α-MSH).Immunoturbidimetric method was used to detect serum CRP.Receiver operating characteristic(ROC)curves were used to evaluate serum PTX3,and the value ofα-MSH and CRP in diagnosis of bacterial infection in chest trauma.Logistic regression was performed to analyze the influencing factors of bacterial infection after trauma.Results The expression levels of serum PTX3 and CRP in patients with trauma were higher(P<0.05),while that ofα-MSH was lower than those in the controls(P<0.05),respectively.The levels of serum PTX3 and CRP in the trauma group increased within 1 day after admission,decreased from 1 to 7 days,and became lower than the level at admission after 7 days.The level of serumα-MSH in the trauma group decreased within 1 day after admission,and showed an upward trend from 1 to 7 days(P<0.05).The expression levels of serum PTX3 and CRP in the infection group were higher(P<0.05),while that ofα-MSH was lower than in the non-infectioin group(P<0.05),respectively.The area under the ROC curve,sensitivity,specificity,and Jordan index of serum PTX3,α-MSH and CRP expression levels for prediction of chest trauma complicated with bacterial infection were 0.968,88.0%,93.2%and 0.820,respectively.Logistic multivariate regression analysis showed that both PTX3 and CRP were the risk factors for post-traumatic bacterial infection(P<0.05),whileα-MSH was a protective factor(P<0.05).Conclusion The levels of serum PTX3 and CRP increased significantly during the perio
作者
高军
葛宇君
张军
GAO Jun;GE Yu-jun;ZHANG Jun(Cardiothoracic surgery,J taxing Second Hospital,Jiaxing,Zhejiang 314000,China;不详)
出处
《中国微生态学杂志》
CAS
CSCD
2021年第6期674-678,共5页
Chinese Journal of Microecology
基金
嘉兴市科技计划项目(2019AD32200)。
关键词
胸部创伤
血清
正五聚蛋白
Α-黑素细胞刺激素
C-反应蛋白
创伤后细菌感染
Chest trauma
Serum
Pentameric protein
α-melanocyte stimulating hormone
C-reactive protein
Post-traumatic bacterialinfection
