摘要
目的观察不同创面感染深度的糖尿病足患者病原菌分布,分析患者炎症指标表达状况。方法纳入2020年1月—2022年1月杭州市中医院67例糖尿病足患者进行前瞻性研究,依据病变是否累及骨关节分为深度感染组(n=28)与浅度感染组(n=39),对所有患者进行病原菌及血清炎症指标检测,观察2组病原菌分布及耐药性,并采用点二列相关性分析炎症指标与感染的关系。结果深度感染组以革兰阴性菌为主,占53.66%,浅度感染组以革兰阳性菌为主,占56.10%。2组间病原菌分布比较差异有统计学意义(P<0.05);深度感染组C-反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)水平高于浅度感染组(P<0.05);经点二列相关性分析,CRP、IL-6、IL-17、TNF-α水平与感染深度成正相关(r值分别为0.557、0.447、0.769、0.621,P<0.05)。结论深度感染的糖尿病足患者以革兰阴性菌为主,浅度感染者以革兰阳性菌为主,病原菌耐药率较高,应结合药敏试验结果选择合适的抗菌药物;此外该症炎症指标呈升高表达,且其表达水平与感染深度密切相关。
Objective This paper aims to observe the distribution and drug resistance of pathogenic bacteria in diabetic foot patients with different wound infection depths,and analyze the inflammatory indicators and their relationship with the depth of infection.Methods Sixty-seven patients with diabetic foot in Hangzhou Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were included in the study.They were divided into deep infection group(n=28)and shallow infection group(n=39)according to whether the lesions had affected bone and joints.Pathogenic bacteria and serum inflammatory indicators were detected in all patients,and the distribution and drug resistance of pathogenic bacteria in the two groups were observed.The relationship between inflammatory indicators and infection was analyzed by point column correlation.Results Among 67 patients with diabetic foot,28 were deep infection and 39 were superficial infection.Gram negative bacteria accounted for 53.66%in the deep infection group,while gram positive bacteria accounted for 56.10% in the shallow infection group.There was statistical significance on the difference in the distribution of pathogenic bacteria between the two groups(P<0.05).The levels of C-reactive protein(CRP),interleukin-6(IL-6),interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)in deep infection group were higher than those in shallow infection group,and the differences were statistically significant(P<0.05).The point binary correlation analysis showed that the levels of CRP,IL-6,IL-17 and TNF-αwere positively correlated with the depth of infection(r=0.557,r=0.447,r=0.769,r=0.621,P<0.05).Conclusion Gram negative bacteria is the main pathogen in the patients with deep infection of diabetic foot,and gram positive bacteria is the main pathogen in the patients with shallow infection.The drug resistance rate of pathogenic bacteria is high.It is necessary to select appropriate antibacterial drugs according to the results of drug sensitivity test.In addition,the expression of inflammatory indicators is significantly increased,and the expression level is closely related to the depth of infection.
作者
张言涛
周黎明
曲悦君
ZHANG Yan-tao;ZHOU Li-ming;QU Yue-jun(Surgery 1,Hangzhou Hospital of Traditional Chinese Medicine,Zhejiang 310007,China;不详)
出处
《中国卫生检验杂志》
CAS
2023年第15期1835-1838,共4页
Chinese Journal of Health Laboratory Technology
关键词
糖尿病足
感染
病原菌分布
炎症指标
Diabetic foot
Infection
Distribution of pathogenic bacteria
Inflammatory indicator
