摘要
目的探讨GustiloⅢ型开放性骨折患者术后感染病原菌及炎症因子和免疫指标改变。方法选取2018年2月至2021年3月在三亚中心医院(海南省第三人民医院)骨科接受治疗的92例GustiloⅢ型开放性骨折患者为研究对象。依据患者术后感染发生情况,将术后发生感染者纳入感染组(n=30),术后未发生感染者纳入未感染组(n=62)。观察GustiloⅢ型开放性骨折患者术后感染病原菌分布情况,比较两组患者炎症因子、免疫指标的差异。结果 30例患者中共检测出30株病原菌,其中革兰阳性菌占比最大,为60.00%,革兰阴性菌占33.33%,真菌占比6.67%;感染组IL-4、IL-6、TNF-α水平均高于未感染组,差异有统计学意义(P<0.05);感染组CD3+、CD4+、CD4+/CD8+水平均较未感染组低,CD8+水平较未感染组高,差异有统计学意义(P<0.05);感染组SAA水平高于未感染组,差异有统计学意义(P<0.05);Spearman相关分析表明,IL-4、IL-6、TNF-α、CD8+、SAA水平与术后感染呈负相关(P<0.05),CD3+、CD4+、CD4+/CD8+与术后感染呈正相关(P<0.05)。结果 GustiloⅢ型开放性骨折患者术后感染以革兰阳性菌为主,与炎症因子和T淋巴细胞亚群有着密切关系。
Objective To investigate the postoperative infection of pathogenic bacteria,inflammatory factors and immune indicators in patients with Gustilo type Ⅲ open fracture. Methods A total of92 patients with Gustilo typeⅢ open fractures who were treated in the Orthopedics Department of Sanya Central Hospital(The Third People ’ s Hospital of Hainan)from February 2018 to March 2021 were selected as the research objects. According to the incidence of postoperative infection of patients,postoperative infections were included in the infection group(n=30),and those without postoperative infection were included in the uninfected group(n=62). The distribution of infectious pathogens in patients with Gustilo type Ⅲ open fractures was observed,and the differences in inflammatory factors and immune indicators between the two groups were compared. Results A total of 30 pathogenic bacteria were detected in 30 patients,among which gram-positive bacteria accounted for the largest proportion of 60.00%,gram-negative bacteria accounted for 33.33%,and fungi accounted for 6.67%;The levela of IL-4,IL-6,and TNF-α in the infection group were higher than those in the uninfected group(P<0.05). The levels of CD3+,CD4+,CD4+/CD8+ in the infected group were lower than those in the uninfected group,and the level of CD8+ was higher than that in the uninfected group,with statistical significance(P<0.05). The level of SAA in the infected group was higher than that in the uninfected group,and the difference was statistically significant(P<0.05). Spearman correlation analysis showed that IL-4,IL-6,TNF-α,CD8+,and SAA levels were negatively correlated with postoperative infection(P<0.05),and CD3 +,CD4 +,CD4 +/CD8 + were positively correlated with postoperative infection(P<0.05). Conclusion Postoperative infection in patients with Gustilo typeⅢ open fractures is dominated by Gram-positive bacteria,which are closely related to inflammatory factors and T lymphocyte subsets.
作者
吴兴源
张国如
陈尉
潘辉龙
杜秀藩
WU Xingyuan;ZHANG Guoru;CHEN Wei;PAN Huilong;DU Xiupan(Osteoarthrosurgery,Sanya Central Hospital(The Third Peoples Hospital of Hainan)SanYa,HaiNan,China,572000;Sports Medicine,Hainan Provincial Peoples Hospital,HaiKou,HaiNan,China,570311)
出处
《分子诊断与治疗杂志》
2022年第2期241-244,248,共5页
Journal of Molecular Diagnostics and Therapy
基金
海南省卫生厅课题(20A200467)。
关键词
GustiloⅢ型
开放性骨折
术后感染
病原菌
炎症因子
免疫指标
Gustilo typeⅢ
Open fractures
Postoperative infection
Pathogenic bacteria
Inflammatory factors
Immune indicators
