目的分析创伤弧菌感染患者的临床特点和预后的相关危险因素。方法收集2003年4月至2014年10月浙江大学附属第一医院经病原学检查确诊为创伤弧菌感染的患者临床资料,根据结局把患者分为治愈组和死亡组,统计分析使用SPSS 20.0软件,其中计...目的分析创伤弧菌感染患者的临床特点和预后的相关危险因素。方法收集2003年4月至2014年10月浙江大学附属第一医院经病原学检查确诊为创伤弧菌感染的患者临床资料,根据结局把患者分为治愈组和死亡组,统计分析使用SPSS 20.0软件,其中计数资料用独立样本t检验,计量资料采用卡方检验,P<0.05为差异有统计学意义。结果共有13例患者确诊为创伤弧菌感染,其中男性患者8例,女性患者5例;11例有肝病基础;死亡患者3例,治愈患者10例;临床表现休克(3例vs 2例,χ2=7.315,P<0.05)、多器官功能衰竭(3例vs 1例,χ2=9.547,P<0.05)、蜂窝织炎(3例vs 3例,χ2=5.728,P<0.05)的患者数量在两组中比较差异有统计学意义;实验室检测中,两组患者的血小板计数(9.00±1.73 vs 84.20±69.93,t=3.397,P<0.05)、凝血酶原时间(42.30±5.31 vs 54.08±22.44,t=-7.565,P<0.05)、部分活化凝血酶原时间(102.83±39.42 vs 54.38±22.44,t=-2.653,P<0.05)、国际标准化比值(3.12±0.24 vs 1.47±0.40,t=-5.400,P<0.05)等差异均有统计学意义。结论创伤弧菌感染在我国沿海地区散发流行,合并肝病的患者病死率更高,患者出现休克、多器官功能衰竭、蜂窝织炎以及血小板计数降低,凝血酶原时间、部分活化凝血酶原时间、国际标准化比值延长提示预后不良。展开更多
Background Septicemia and inflammation-mediated septic shock caused by Vibrio vulnificus （VV） is strongly associated with chronic liver disease. This study examined the effects of antimicrobial therapy on expression...Background Septicemia and inflammation-mediated septic shock caused by Vibrio vulnificus （VV） is strongly associated with chronic liver disease. This study examined the effects of antimicrobial therapy on expression of hepatic toll-like receptors and inflammatory cytokines in rats with alcohol-induced liver disease complicated by VV sepsis. Methods Male Sprague-Dawley rats were assigned to the following treatment groups： normal control （N）, alcoholic liver disease control （A）, antimicrobial-treated alcoholic liver disease control （AA）, alcoholic liver disease with VV sepsis （AV）, and antimicrobial-treated alcoholic liver disease with VV sepsis （AVA）. Alcohol-induced liver disease was observed in all groups except N. Expression of mRNAs encoding hepatic toll-like receptors 2 and 4, myeloid differentiation protein-2, tumor necrosis factor-α （TNF-α）, interleukin （IL）-1β, IL-6 and IL-10 was determined by RT-PCR. Results mRNAs encoding toll-like receptors 2 and 4 and myeloid differentiation protein-2 were significantly up-regulated in group AV as compared to control groups at 2-24 hours of sepsis; peak expression occurred at 12 hours. These mRNAs were also up-regulated in group AVA but to lesser degrees than in group AV at comparable time post-infection, mRNAs encoding TNF-α, IL-1β and IL-6 were significantly elevated in group AV as a function of infection. In group AVA as compared to AV, expression of TNF-α and IL-1β mRNAs was lower at 12-24 hours post-infection and expression of IL-6 mRNA was lower at 24 hours post-infection. Compared with control groups, IL-10 mRNA expression in group AV was markedly higher at 12-24 hours of sepsis. Expression of IL-10 mRNA was lower in group AVA as compared to AV at 24 hours of sepsis. Conclusions Antimicrobial therapy reduces expression of toll-like receptors and cytokines in rats with alcohol-induced liver disease complicated by VV sepsis. Monitoring hepatic toll-like receptor and cytokine expression during antibiotic therapy may be valua展开更多
文摘目的分析创伤弧菌感染患者的临床特点和预后的相关危险因素。方法收集2003年4月至2014年10月浙江大学附属第一医院经病原学检查确诊为创伤弧菌感染的患者临床资料,根据结局把患者分为治愈组和死亡组,统计分析使用SPSS 20.0软件,其中计数资料用独立样本t检验,计量资料采用卡方检验,P<0.05为差异有统计学意义。结果共有13例患者确诊为创伤弧菌感染,其中男性患者8例,女性患者5例;11例有肝病基础;死亡患者3例,治愈患者10例;临床表现休克(3例vs 2例,χ2=7.315,P<0.05)、多器官功能衰竭(3例vs 1例,χ2=9.547,P<0.05)、蜂窝织炎(3例vs 3例,χ2=5.728,P<0.05)的患者数量在两组中比较差异有统计学意义;实验室检测中,两组患者的血小板计数(9.00±1.73 vs 84.20±69.93,t=3.397,P<0.05)、凝血酶原时间(42.30±5.31 vs 54.08±22.44,t=-7.565,P<0.05)、部分活化凝血酶原时间(102.83±39.42 vs 54.38±22.44,t=-2.653,P<0.05)、国际标准化比值(3.12±0.24 vs 1.47±0.40,t=-5.400,P<0.05)等差异均有统计学意义。结论创伤弧菌感染在我国沿海地区散发流行,合并肝病的患者病死率更高,患者出现休克、多器官功能衰竭、蜂窝织炎以及血小板计数降低,凝血酶原时间、部分活化凝血酶原时间、国际标准化比值延长提示预后不良。
文摘Background Septicemia and inflammation-mediated septic shock caused by Vibrio vulnificus （VV） is strongly associated with chronic liver disease. This study examined the effects of antimicrobial therapy on expression of hepatic toll-like receptors and inflammatory cytokines in rats with alcohol-induced liver disease complicated by VV sepsis. Methods Male Sprague-Dawley rats were assigned to the following treatment groups： normal control （N）, alcoholic liver disease control （A）, antimicrobial-treated alcoholic liver disease control （AA）, alcoholic liver disease with VV sepsis （AV）, and antimicrobial-treated alcoholic liver disease with VV sepsis （AVA）. Alcohol-induced liver disease was observed in all groups except N. Expression of mRNAs encoding hepatic toll-like receptors 2 and 4, myeloid differentiation protein-2, tumor necrosis factor-α （TNF-α）, interleukin （IL）-1β, IL-6 and IL-10 was determined by RT-PCR. Results mRNAs encoding toll-like receptors 2 and 4 and myeloid differentiation protein-2 were significantly up-regulated in group AV as compared to control groups at 2-24 hours of sepsis; peak expression occurred at 12 hours. These mRNAs were also up-regulated in group AVA but to lesser degrees than in group AV at comparable time post-infection, mRNAs encoding TNF-α, IL-1β and IL-6 were significantly elevated in group AV as a function of infection. In group AVA as compared to AV, expression of TNF-α and IL-1β mRNAs was lower at 12-24 hours post-infection and expression of IL-6 mRNA was lower at 24 hours post-infection. Compared with control groups, IL-10 mRNA expression in group AV was markedly higher at 12-24 hours of sepsis. Expression of IL-10 mRNA was lower in group AVA as compared to AV at 24 hours of sepsis. Conclusions Antimicrobial therapy reduces expression of toll-like receptors and cytokines in rats with alcohol-induced liver disease complicated by VV sepsis. Monitoring hepatic toll-like receptor and cytokine expression during antibiotic therapy may be valua
