摘要
目的 研究重症脑出血患者肺部感染病原菌和炎症因子及Toll样受体4(TLR4)/核因子-κB(NF-κB)信号通路表达变化。方法 回顾性收集2020年8月-2022年8月江南大学附属医院收治的159例重症脑出血患者临床资料,根据患者是否发生肺部感染将其分为感染组(31例)和未感染组(128例),统计两组一般资料及重症脑出血肺部感染患者病原菌情况,比较两组血清炎症因子水平及TLR4/NF-κB信号通路指标,采用Pearson相关性分析TLR4/NF-κB信号通路与血清炎症因子的相关性。结果 31例重症脑出血肺部感染患者共检出39株病原菌,其中革兰阴性菌25株占64.10%,以鲍氏不动杆菌、肺炎克雷伯菌为主;革兰阳性菌检出13株占33.33%,以金黄色葡萄球菌为主;真菌1株占2.56%;感染组血清降钙素原(PCT)、C-反应蛋白(CRP)、高迁移率族蛋白B1(HMGB1)、TLR4、NF-κB、磷酸化NF-κB抑制蛋白(p-IκB)、肿瘤坏死因子-α(TNF-α)水平高于未感染组(P<0.05);Pearson相关性分析结果显示,重症脑出血肺部感染患者血清TLR4、NF-κB、p-IκB蛋白、TNF-α水平与血清PCT、CRP、HMGB1水平呈正相关(P均<0.05)。结论 重症脑出血患者肺部感染病原菌主要为鲍氏不动杆菌、肺炎克雷伯菌、金黄色葡萄球菌,肺部感染的发生可引起患者血清炎症因子水平和TLR4/NF-κB信号通路指标水平升高,TLR4/NF-κB信号通路指标与血清炎症因子水平呈正相关。
OBJECTIVE To investigate pathogenic bacteria of pulmonary infection,and the changes of inflammatory factors and toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB) signaling pathway expression in patients with severe cerebral hemorrhage.METHODS The clinical data of 159 patients with severe cerebral hemorrhage admitted to the Affiliated Hospital of Jiangnan University from Aug.2020 to Aug.2022 were retrospectively collected,and the patients were divided the into the infected group(31 cases) and the uninfected group(128 cases) according to whether they had pulmonary infection or not.The general information of the two groups and the distribution of pathogenic bacteria in patients with severe cerebral hemorrhage and pulmonary infection were analyzed.Levels of serum inflammatory factor and TLR4/NF-κB signaling pathway indexes were compared between the two groups.Pearson correlation was used to analyze the correlation between TLR4/NF-κB signaling pathway and serum inflammatory factors.RESULTS A total of 39 strains of pathogenic bacteria were detected in 31 patients with severe cerebral hemorrhage and pulmonary infection,of which 25 strains of Gram-negative bacteria accounted for 64.10%,mainly Acinetobacter bauerii and Klebsiella pneumoniae;13 strains of gram-positive bacteria accounted for 33.33%,mainly Staphylococcus aureus.1 strain of fungus accounted for 2.56%.Serum levels of procalcitonin(PCT),C-reactive protein(CRP),high mobility group protein B1(HMGB1),TLR4,NF-κB,phosphorylated inhibitor of NF-κB(P-I-κB),tumor necrosis factor-α(TNF-α) in the infected group were higher than those in the uninfected group(P<0.05);Pearson correlation analysis showed that serum levels of TLR4,NF-κB,p-i-κB protein and TNF-α were positively correlated with serum levels of PCT,CRP and HMGB1 in patients with severe cerebral hemorrhage and pulmonary infection(all P<0.05).CONCLUSION The pathogenic bacteria of pulmonary infection in patients with severe cerebral hemorrhage were mainly Acinetobacter bauerii,Klebsiella pneumoniae a
作者
郑洁
吴卫江
吴智慧
俞岚
戈纯
黄丽丽
ZHENG Jie;WU Wei-jiang;WU Zhi-hui;YU Lan;GE Chun;HUANG Li-li(Affiliated Hospital of Jiangnan University,Jiangsu 214000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第12期1833-1837,共5页
Chinese Journal of Nosocomiology
基金
江苏省卫生健康发展研究中心开放课题基金资助项目(JS2021033)
江苏省中医药管理局面上基金资助项目(MS2021045)。
关键词
重症脑出血
肺部感染
病原菌
炎症因子
Toll样受体4
核因子-ΚB
信号通路
Severe cerebral hemorrhage
Lung infection
Pathogenic bacteria
Inflammatory factors
Toll-like re-ceptor 4
Nuclear factor-kB
Pathway of signal
