摘要
目的探讨开放性骨折感染患者血清促炎及抗炎因子表达,为开放性骨折感染的临床诊治提供参考。方法选取2014年8月-2015年8月在医院诊治100例开放性骨折患者为骨折组、同期门诊进行健康体检的50例正常人群为对照组,骨折组在入院后隔日、对照组在体检时抽血检测白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、可溶性肿瘤坏死因子受体I(sTNF-RI)水平,骨折组同时取创面分泌物行细菌培养。结果骨折组感染者21例,感染发生率为21.00%,培养出病原菌20株,分别为金黄色葡萄球菌12株、大肠埃希菌5株、表皮葡萄球菌2株、肺炎克雷伯菌1株,构成比分别占60.00%、25.00%、10.00%、5.00%;骨折组患者IL-6、TNF-α、IL-4、IL-10、sTNF-RI水平均高于对照组(P<0.05);骨折感染患者IL-6、TNF-α、IL-4、IL-10、sTNF-RI水平分别为(35.45±5.71)ng/L、(42.65±7.89)ng/L、(56.11±13.54)pg/ml、(71.83±15.40)μg/L、(3983.55±945.71)ng/L,均高于骨折无感染患者(14.45±3.56)ng/L、(22.43±4.67)ng/L、(30.32±5.21)pg/ml、(50.15±11.01)μg/L、(2168.61±480.32)ng/L,比较差异有统计学意义(P<0.05)。结论开放性骨折患者血清促炎及抗炎因子表达均明显升高,骨折感染可加重机体促炎及抗炎反应。
OBJECTIVE To explore the expression of serum pro-inflammatory and anti-inflammatory factors in patients with open fracture infection so as to provide guidance for clinical diagnosis and treatment of the open fracture infection.METHODS A total of 100 patients with open fracture who were treated in hospitals from Aug 2014 to Aug 2015 were chosen as the fracture group,meanwhile,50 healthy people who received physical examination were set as the control group.The blood was drawn from the fracture group on the day after admission and from the control group when they received the physical examination so as to detect the levels of interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）,interleukin-4（IL-4）,interleulin-10（IL-10）,and soluble tumor necrosis factor receptor I（sTNF-RI）.RESULTS Totally 21 patients had infection in the fracture group,with the infection rate 21.00%.A total of 20 strains of pathogens were isolated,including 12（60.00%）strains of Staphylococcus aureus,5（25.00%）strains of Escherichia coli,2（10.00%）strains of Staphylococcus epidermidis,and 1（5.00%）strain of Klebsiella pneumoniae;the wound secretions that were collected from the fracture group were cultured.The levels of IL-6,TNF-α,IL-4,IL-10,and sTNF-RI of the fracture group were higher than those of the control group（P〈0.05）;the levels of IL-6,TNF-α,IL-4,IL-10,and sTNF-RI of the patients with fracture infection were respectively（35.45±5.71）ng/L,（42.65±7.89）ng/L,（56.11±13.54）pg/ml,（71.83±15.40）μg/L,and（3983.55±945.71）ng/L,higher than（14.45±3.56）ng/L,（22.43±4.67）ng/L,（30.32±5.21）pg/ml,（50.15±11.01）μg/L,and（2168.61±480.32）ng/L of the patients without fracture infection,and there was significant difference（P0.05）.CONCLUSION The levels of expression of serum pro-inflammatory and anti-inflammatory factors are remarkably elevated in the patients with open fracture,and the fracture infection may aggravate the pro-inflammatory and anti-inflammatory response.
作者
卜文君
郑莉丽
钟奕
廖冬梅
胡骏
方航
BU Wen-jun ZHENG Li-li ZHONG Yi LIAO Dong-mei HU Jun FANG Hang(South Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第4期846-848,879,共4页
Chinese Journal of Nosocomiology
基金
2015广东省医学科研基金立项课题(A2015422)
关键词
开放性骨折
感染
促炎因子
抗炎因子
Open fracture
Infection
Pro-inflammatory factor
Anti-inflammatory factor
