摘要
目的探究老年肺炎多药耐药菌感染病原菌及外周血辅助性T细胞(Th)、调节性T细胞(Treg)和细胞因子表达对预后的影响.方法选取江阴市人民医院2021年7月-2023年7月收治的101例老年肺炎多药耐药菌感染患者为研究组,选择同期收治的105例普通老年肺炎患者为对照组.统计研究组病原菌分布,比较研究组、对照组及研究组患者不同严重程度、不同预后外周血Th9、Th17、Treg、Th17/Treg及转化生长因子(TGF)-β、白细胞介素(IL)-10、IL-23表达;采用Spearman分析其相关性.结果研究组Th9、Th17、Th17/Treg及IL-23高于对照组,Treg及TGF-β、IL-10低于对照组(P<0.05);研究组共培养出病原菌207株,以革兰阴性菌为主,主要为鲍氏不动杆菌、铜绿假单胞菌.研究组患者中,重症组Th9、Th17、Th17/Treg及IL-23高于轻症组、中症组,且中症组高于轻症组;Treg及TGF-β、IL-10低于轻症组、中症组,且中症组低于轻症组(P<0.05).研究组患者中,不良预后组Th9、Th17、Th17/Treg及IL-23高于良好预后组,Treg及TGF-β、IL-10低于良好预后组(P<0.05).Th9、Th17、Th17/Treg及IL-23与老年肺炎多药耐药菌感染严重程度、不良预后呈正相关(P<0.05),Treg及TGF-β、IL-10呈负相关(P<0.05).结论老年肺炎患者多药耐药菌感染病原菌以革兰阴性菌为主,Th、Treg细胞及其细胞因子表达异常,并与老年肺炎多药耐药菌感染的严重程度及预后有相关性.
OBJECTIVE To explore the expressions of helper T cell(Th),regulatory T cell(Treg)and their cyto-kines in peripheral blood of the elderly pneumonia patients with multidrug-resistant organisms(MDROs)infec-tions and observe the influence on prognosis.METHODS A total of 101 elderly pneumonia patients with MDROs infections who were treated in Jiangyin People's Hospital from Jul 2021 to Jul 2023 were assigned as the study group,meanwhile,105 common elderly patients with pneumonia were chosen as the control group.The distribu-tion of pathogens isolated from the study group was statistically analyzed.The expression levels of peripheral blood Th9,Th17,Treg,Th17/Treg,transforming growth factor(TGF)-β,interleukin(IL)-10 and IL-23 were observed and compared between the study group and the control group and among the patients with different se-verities,different treatment outcomes in the study group.The correlation was analyzed by Spearman.RESULTS The levels of Th9,Th17,Th17/Treg and IL-23 of the stud group were higher than those of the control group,while the levels of Treg,TGF-βand IL-10 of the study group were lower than those of the control group(P<0.05).Totally 207 strains of pathogens were isolated from the study group,among which gram-negative bacteria were dominant,and Acinetobacter baumannii and Pseudomonas aeruginosa were the predominant species.Among the patients of the study group,the levels of Th9,Th17,Th17/Treg and IL-23 of the severe group were higher than those of the moderate group and the mild group,and the levels of the above indexes of the moderate group were higher than those of the mild group;the levels of Treg,TGF-βand IL-10 of the severe group were lower than those of the moderate group and the mild group,and the levels of the above indexes of the moderate group were lower than those of the mild group(P<0.05).Among the patients of the study group,the levels of Th9,Th17,Th17/Treg and IL-23 of the poor prognosis group were higher than those of the favorable prognosis group,while the levels of Treg,TGF
作者
蔡雯雯
顾一航
张慧
缪铱滟
王兰
CAI Wen-wen;GU Yi-hang;ZHANG Hui;MIAO Yi-yan;WANG Lan(The Jiangyin Clinical College of Xuzhou Medical University,Xuzhou,Jiangsu 214400,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第14期2118-2123,共6页
Chinese Journal of Nosocomiology
基金
国家自然科学基金青年基金资助项目(82000012)
江苏省重点实验室开放研究基金资助项目(XZSYSKF2020021,XZSYSKF2022002)
无锡市卫生健康委中青年拔尖人才基金资助项目(BJ2023101)
江阴市中青年卫生优秀人才基金资助项目(JYOYT202301)。
关键词
老年肺炎
多药耐药菌感染
病原菌
辅助性T淋巴细胞
调节性T细胞
预后
The elderly with pneumonia
Multidrug-resistant organism infection
Pathogen
Helper T lymphocyte
Regulator T cell
Prognosis
