摘要
目的探讨肺癌术后肺部感染的病原菌特征及对血清髓样细胞触发受体-1(soluble form of triggering receptors expressed on myeloid cell-1,sTREM-1)、降钙素原(procalcitotin,PCT)、血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)水平的影响。方法选取2014年1月至2017年12月金华市中心医院和绍兴市人民医院收治的肺癌术后患者300例,其中发生肺部感染者35例作为感染组,随机选取未发生肺部感染者35例作为非感染组,健康体检者35例作为对照组。检测肺部感染的病原学分布和耐药情况,测定血清sTREM-1、PCT、VEGF水平。结果35例肺部感染患者中痰液培养阳性33例,共培养出菌株42株。革兰阳性菌9株(21.43%),主要为金黄色葡萄球菌6株(14.29%);革兰阴性菌31株(73.81%),主要为肺炎克雷伯菌10株(23.81%)和鲍曼不动杆菌和9株(21.43%);真菌2株(4.76%)。金黄色葡萄球菌对青霉素100.00%耐药,其次为苯唑西林和克林霉素,耐药率分别为66.67%和50.00%。肺炎克雷伯菌对氨苄西林和环丙沙星耐药率高,耐药率分别为90.00%和60.00%;鲍曼不动杆菌主要对氨苄西林、环丙沙星、阿米卡星耐药率高,耐药率分别为77.78%、66.67%和66.67%。感染组血清sTREM-1、PCT、VEGF水平均高于非感染组和对照组,差异有统计学意义(F=227.821、1311.052、25.020,P<0.01)。结论肺癌术后肺部感染的病原菌以革兰阴性菌为主,肺部感染患者血清sTREM-1、PCT、VEGF水平升高。
Objective To understand the characteristics of pathogenic bacteria in postoperative lung infection in patients with lung cancer and to discuss its effect on serum levels of soluble form of triggering receptors expressed on myeloid cell-1(sTREM-1),procalcitonin(PCT),and vascular endothelial growth factor(VEGF).Methods Lung cancer patients underwent surgery in Jinhua Municipal Central Hospital and Shaoxing People′s Hospital from January 2014 to December 2017 were selected and divided into infection group(n=35)and non-infection group(n=35).35 healthy individuals were also enrolled as study controls.The etiological distribution of infection and the drug resistance of bacteria were determined.The serum levels of sTREM-1,PCT,and VEGF were also measured.Results Among the patients with postoperative lung cancer,33 of them were positive for sputum culture.A total of 42 strains were isolated,9(21.43%)were Gram-positive and 6 stains(14.29%)were Staphylococcus aureus.31 strains(73.81%)were Gram-negative,10 strains(23.81%)were Klebsiella pneumoniae and 9 strains(21.43%)were Acinetobacter baumannii.There were 2 strains(4.76%)of fungi.The drug resistance rates of Staphylococcus aureus were 100.00%to penicillin,66.67%to oxacillin and 50.00%to clindamycin.The drug resistance rates of Klebsiella pneumoniae to ampicillin and to ciprofloxacin were as high as 90.00%and 60.00%.Acinetobacter baumannii had higher resistance rates of 77.78%,66.67%and 66.67%to ampicillin,ciprofloxacin and amikacin.The serum levels of sTREM-1,PCT,and VEGF in the infection group were higher than those in the non-infection group and the control group(P<0.05).Conclusions Gram-negative bacteria are the major pathogens of pulmonary infection in patients with lung cancer after surgery and the serum levels of sTREM-1,PCT,and VEGF increase in patients with pulmonary infection.
作者
楼洋
陈献国
许博
李献帅
徐小义
卢增新
LOU Yang;CHEN Xian-guo;XU Bo;LI Xian-shuai;XU Xiao-yi;LU Zeng-xin(Department of Cardiothoracic Surgery,Jinhua Municipal Central Hospital,Jinhua,Zhejiang 321000,China;不详)
出处
《中国预防医学杂志》
CAS
CSCD
2020年第4期375-378,共4页
Chinese Preventive Medicine
基金
浙江省医药卫生科技基金资助项目(2015KYB403)
关键词
肺癌
肺部感染
病原菌
髓样细胞触发受体-1
降钙素原
血管内皮细胞生长因子
Lung cancer
Pulmonary infection
Pathogen
Soluble form of triggering receptors expressed on myeloid cell-1
Procalcitonin
Vascular endothelial growth factor
