摘要
目的探讨老年全身麻醉手术患者肺部感染血清还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶(NADPH oxi-dase)、Toll样受体4(TLR4)、前白蛋白(PA)水平.方法选取2018年12月-2023年4月临安区第一人民医院收治的79例合并肺部感染的老年全身麻醉手术患者作为病例组,89例未合并肺部感染的老年全身麻醉手术患者作为对照组;统计老年全身麻醉手术患者肺部感染的病原菌特征;检测血清NADPH oxidase相关亚基P22、P67、TLR4、PA水平;比较两组及不同肺部感染程度的老年全身麻醉手术患者血清P22、P67、TLR4、PA水平.结果79例合并肺部感染的老年全身麻醉手术患者共培养分离病原菌86株,革兰阳性菌33株占38.37%,革兰阴性菌53株占61.63%;血清P22、P67、TLR4水平病例组比对照组高(P<0.05),且中度组和重度组比轻度组高(P<0.05),重度组比中度组高(P<0.05);血清PA水平病例组比对照组低(P<0.05),且中度组和重度组比轻度组低(P<0.05),重度组比中度组低(P<0.05);Spearman相关性分析结果发现血清P22、P67、TLR4水平与老年全身麻醉手术患者肺部感染程度呈正相关(r=0.760,0.712,0.755,P均<0.05),血清PA水平与老年全身麻醉手术患者肺部感染程度呈负相关(r=-0.773,P<0.05).结论老年全身麻醉手术患者肺部感染以革兰阴性菌感染居多,且肺部感染发生后血清NADPH oxidase相关亚基P22、P67、TLR4水平呈高表达,PA水平呈低表达;NADPH oxidase相关亚基P22、P67、TLR4、PA水平与患者肺部感染程度密切相关.
OBJECTIVE To investigate the levels of serum niacinamide adenine dinucleotide phosphate oxidase(NADPH oxidase),Toll-like receptor 4(TLR4)and prealbumin(PA)in elderly patients with pulmonary infection undergoing general anesthesia surgery.METHODS Totally 79 elderly patients with pulmonary infection undergoing general anesthesia surgery who were admitted to the First People's Hospital of Lin'an District from Dec.2018 to Apl.2023 were retrospectively selected as the case group,and 89 elderly patients without pulmonary infection undergoing general anesthesia surgery were selected as the control group.The pathogenic bacteria characteristics of pulmonary infection in elderly patients undergoing general anesthesia surgery were analyzed.Serum NADPH oxidase-related subunit P22,P67,TLR4 and PA levels were measured.Serum P22,P67,TLR4 and PA levels in elderly patients undergoing general anesthesia surgery in two groups and with different degrees of pulmonary infection were compared.RESULTS A total of 86 strains of pathogenic bacteria were isolated and co-cultured from 79 elderly patients with pulmonary infection undergoing general anesthesia surgery,of which 33 strains of gram-positive accounted for 38.37%,53 strains of gram-negative accounted for 61.63%.Serum levels of P22.P67 and TLR4 in case group were higher than those in control group(P<0.05),moderate group and severe group were higher than mild group(P<0.05),and severe group was higher than moderate group(P<0.05).Serum PA level in case group was lower than control group(P<o.05),moderate group and severe group were lower than mild group(P<0.05),and severe group was lower than moderate group(P<0.05).Spearman correlation analysis showed that serum P22,P67,TLR4 levels were positively correlated with the degree of pulmonary infection in elderly patients undergoing general anesthesia surgery(r=0.760;0.712;0.755,all P<0.05),serum PA level was negatively correlated with the degree of pulmonary infection in elderly patients undergoing general anesthesia surgery(r=-0.773,P<0.05)
作者
王岑岑
祁琦
应江明
WANG Cen-cen;QI Qi;YING Jiang-ming(The First People's Hospital of Lin'an District,Hangzhou,Zhejiang 311300,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第12期1821-1825,共5页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技计划基金资助项目(2021KY534)。
