[1]贾 杉,加 莉△.外伤性脑出血患者术后感染病原菌分布特点及与炎症反应和氧化应激关系探讨[J].陕西医学杂志,2020,49(5):564-567.
　JIA Shan,JIA Li..Distribution of pathogenic bacteria in patients with traumatic cerebral hemorrhage after operation and expression of inflammatory stress index in serum[J].,2020,49(5):564-567.
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外伤性脑出血患者术后感染病原菌分布特点及与炎症反应和氧化应激关系探讨
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年5期
页码:
564-567
栏目:
临床研究
出版日期:
2020-05-05

文章信息/Info

Title:
Distribution of pathogenic bacteria in patients with traumatic cerebral hemorrhage after operation and expression of inflammatory stress index in serum
文章编号:
DOI:10.3969/j.issn.10007377.2020.05.014
作者:
贾 杉; 加 莉△
陕西省中医医院(西安710003)
Author(s):
JIA Shan; JIA Li.
Shaanxi Traditional Chinese Medicine Hospital(Xi'an 710003)
关键词:
外伤性脑出血;  外科学;  感染;  病原菌;  炎症反应;  氧化应激
Keywords:
Traumatic cerebral hemorrhage;  Surgery;  Infection;  Pathogenic bacteria;  Inflammation reaction;  Oxidative stress
分类号:
R651.15
文献标志码:
A
摘要:
目的:探讨外伤性脑出血患者术后感染的病原菌情况以及血清炎症反应和氧化应激指标的表达特点。方法:收集150例外伤性脑出血患者,根据术后有无发生感染分为未感染组(n=85)和感染组(n=65),同时选择50例同期健康志愿者作为对照组。收集整理感染组患者感染部位和病原菌的分布情况,同时收集三组受检者空腹静脉血5 ml,分别检测血清肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-2(IL-2)、超氧化物歧化酶(SOD)和丙二醛(MDA)等炎症反应和氧化应激指标水平,并分析其表达特点。结果:感染组术后感染多发生在呼吸道、肺部和颅内等部位,分别占32.31%、23.08%和18.46%。从65份送检样本中共分离病原菌73株,以革兰阴性菌为主,占56.16%,其次是革兰阳性菌、真菌,分别占36.99%、6.85%。感染组血清TNF-α、CRP、PCT、MDA水平均高于未感染组和对照组,同时血清IL-2、SOD水平低于未感染组和对照组,组间比较差异有统计学意义(P<0.05),而未感染组和对照组上述炎症应激指标比较均无统计学差异(P>0.05)。结论:外伤性脑出血患者术后感染的主要病原菌是革兰阴性菌。术后感染的发生可能与炎症反应、氧化应激存在紧密联系。
Abstract:
Objective:To investigate the pathogenic bacteria of postoperative infection in patients with traumatic cerebral hemorrhage and the expression characteristics of serum inflammatory stress indicators. Methods:A total of 150 patients with traumatic cerebral hemorrhage were collected. They were divided into two groups according to whether the postoperative infection occurred:uninfected group(n=85)and infected group(n=65). 50 healthy volunteers in the same period were selected as control group. The distribution of infection site and Gram negative/positive identification of pathogenic bacteria in the infected group were collected and sorted out. 5 ml of fasting venous blood was collected from the three groups of patients,and the levels of serum tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP),procalcitonin(PCT),interleukin-2(IL-2),superoxide dismutase(SOD)and malondialdehyde(MDA)were detected,and their expression characteristics were analyzed. Results:In the infected group,the postoperative infections mainly occurred in respiratory tract,lung and intracranial areas,accounting for 32.31%,23.08% and 18.46% respectively. A total of 73 strains of pathogenic bacteria were isolated from 65 samples,mainly Gram-negative bacteria,accounting for 56.16%,followed by Gram-positive bacteria and fungi,accounting for 36.99% and 6.85% respectively. The levels of serum TNF-α,CRP,PCT and MDA in the infected group were higher than those in the uninfected group and the control group,while the levels of serum IL-2 and SOD were significantly lower than those in the uninfected group and the control group(P<0.05),but there was no significant difference in the above-mentioned inflammatory stress indicators between the uninfected group and the control group(P>0.05). Conclusion:Gram-negative bacteria are the main pathogens of postoperative infection in patients with traumatic cerebral hemorrhage.Postoperative infection may be closely related to inflammatory reaction and oxidative stress.

参考文献/References:

[1] 周小龙,张 鹏,韦 玮.创伤性脑出血患者的早期治疗及预后[J]. 中华神经外科疾病研究杂志,2017,16(4):325-328.
[2] 满慧静,宋宏颖,张海燕,等. 康复介入时机对卧床脑出血患者并发症的影响[J]. 中国康复,2018,33(1):48-50.
[3] 许连芳,赵菊梅.系统化护理干预对脑出血患者情绪和依从性及并发症的影响[J].陕西医学杂志,2017,46(11):1615-1616.
[4] 季志刚,王颖建,周雪东.不同手术时机对多发性颅内血肿患者预后与神经损伤修复效果比较[J].湖南师范大学学报:医学版,2018,15(1):138-141.
[5] 王 强,孙建怀,国义民.创伤性脑出血患者脑组织IL-1β、TNF-α与NF-κB水平变化与其预后的关系分析[J]. 陕西医学杂志,2017,46(12):1653-1654.
[6] 邓丽萍,李雪一,龚龙飞,等. 老年高血压脑出血患者术后医院感染危险因素及预防干预研究[J]. 中华医院感染学杂志,2017,27(19):4443-4445.
[7] 李林山,夏小辉. 高血压脑出血微创穿刺术后颅内感染的病原菌变化及危险因素分析[J]. 中国实用神经疾病杂志,2017,20(1):3-7.
[8] 何晓黎. 高血压性脑出血术后患者下呼吸道感染病原菌分布特征及危险因素分析[J].现代实用医学,2016,28(5):615-617.
[9] 李海峰,茹小红,段志斌,等. 脑出血微创术后并发颅内感染原因的回顾性分析[J].中国药物与临床,2018,18(11):120-122.
[10] 徐剑峰,曾令勇,刘 阳,等. 外伤性脑出血患者术后病原菌感染对神经生长因子及抑瘤素M水平的影响研究[J]. 中华医院感染学杂志,2016,26(8):1755-1757.
[11] 李林山,夏小辉. 高血压脑出血微创穿刺术后颅内感染的病原菌变化及危险因素分析[J]. 中国实用神经疾病杂志,2017,20(1):3-7.
[12] 邹素昭,邹素昭.保金立甦汤对重症肺炎患者血清PCT、hs-CRP水平的影响[J].陕西中医,2016,37(6):652-654.
[13] 白雅红,李月阳,王 华,等. 降钙素原、C反应蛋白、白细胞计数联合检测对医院获得性细菌性肺炎的诊断价值[J]. 陕西医学杂志,2017,46(6):807-809.
[14] 高海荣,张树新,郑 霞,等. 高血压脑出血患者术后肺部感染病原菌分布及外周血指标的诊断评价[J]. 中华医院感染学杂志,2017,27(17):3882-3885.
[15] 柯国秀,王国军,王建生,等. 早期继续出血的自发性脑出血患者不同时间点氧化应激及炎性介质水平的变化[J]. 卒中与神经疾病,2017,24(4):306-309.
[16] 高 吟,张立红,胡锡池,等.外伤性脑出血患者术后感染病原菌分布及其与氧化应激和炎症状态的关系[J]. 神经损伤与功能重建,2018,13(11):565-566,586.

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更新日期/Last Update: 2020-07-28