TNF-α、IFN-γ及eGFR在老年肺结核患者中的表达意义及合并肺部感染患者的病原菌分布特点
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摘要
目的:探讨肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)及肾小球滤过率功能(e GFR)在老年肺结核患者中的表达及合并肺部感染患者的病原菌分布特点。方法:选取2015年1月-2017年12月本院诊治的97例老年肺结核患者作为研究对象,根据患者病情进展程度将其分为病灶超过2个肺野或有空洞形成组(n=36)和病灶未超过2个肺野组(n=61)。入院后抽取空腹血化验血常规,检测TNF-α以及IFN-γ表达水平,同时检测e GFR阳性表达率,并对住院后出现肺部感染的患者进行病原菌检测,分析其分布特点。结果:病灶超过2个肺野或有空洞形成组患者的TNF-α以及IFN-γ表达水平均明显高于病灶未超过2个肺野组,差异均有统计学意义(t=4.277 1、2.789 3,P=0.000 1、0.009 7);两组EGFR阳性表达率比较,差异无统计学意义(t=0.752 1,P=0.651 2)。97例老年患者检测结果显示,阳性标本42例,共分离出致病菌株43株。其中革兰阴性菌检出率最高,共24株,构成比55.81%,其中以铜绿假单胞菌和鲍氏不动杆菌检出株数最高;革兰阳性菌检出18株,构成比41.86%,其中以金黄色葡萄球菌检出率最高。结论:TNF-α、IFN-γ均可作为评价治疗是否成功的参数,病原菌特点以革兰阴性菌感染率最高。
Objective:To explore the expression of TNF-α,IFN-γ and e GFR in elderly patients with pulmonary tuberculosis and distribution characteristics of pathogenic bacteria in patients with complicated with pulmonary infection.Method:A total of 97 elderly patients with pulmonary tuberculosis treated in our hospital from January 2015 to December 2017 were selected as the study objects.According to the degree of disease progression,they were divided into two groups:the lesions were more than 2 lung fields or the cavity formation group(n=36) and the lesions were not more than 2 lung fields groups(n=61).After admission,fasting blood samples were collected to detect the expression of TNF-α and IFN-γ,and the positive expression rate of e GFR was detected. The pathogenic bacteria in the patients with pulmonary infection were detected and their distribution characteristics were analyzed.Result:The expression levels of TNF-α and IFN-γ in patients with more than 2 lung fields or cavities formation group were significantly higher than those in not more than 2 lung fields group,the differences were statistically significant(t=4.277 1,2.789 3;P=0.000 1,0.009 7).There was no significant difference in the positive expression rate of e GFR between the two groups(t=0.752 1,P=0.651 2).The results of 97 elderly patients showed that 43 strains of pathogenic bacteria were isolated from 42 positive specimens.The detection rate of gram-negative bacteria was the highest,24 strains were detected,composition ratio was 55.81%.Among them, pseudomonas aeruginosa and acinetobacter baumannii were the most detected. 18 strains of gram-positive bacteria were detected,and the composition ratio was 41.86%.The detection rate of Staphylococcus aureus was the highest.Conclusion:The TNF-α and IFN-γ can be used as a parameter to evaluate the success of the treatment,which the infection rate of Gram-negative bacteria are the highest in the pathogenic bacteria.
Objective:To explore the expression of TNF-α,IFN-γ and e GFR in elderly patients with pulmonary tuberculosis and distribution characteristics of pathogenic bacteria in patients with complicated with pulmonary infection.Method:A total of 97 elderly patients with pulmonary tuberculosis treated in our hospital from January 2015 to December 2017 were selected as the study objects.According to the degree of disease progression,they were divided into two groups:the lesions were more than 2 lung fields or the cavity formation group(n=36) and the lesions were not more than 2 lung fields groups(n=61).After admission,fasting blood samples were collected to detect the expression of TNF-α and IFN-γ,and the positive expression rate of e GFR was detected. The pathogenic bacteria in the patients with pulmonary infection were detected and their distribution characteristics were analyzed.Result:The expression levels of TNF-α and IFN-γ in patients with more than 2 lung fields or cavities formation group were significantly higher than those in not more than 2 lung fields group,the differences were statistically significant(t=4.277 1,2.789 3;P=0.000 1,0.009 7).There was no significant difference in the positive expression rate of e GFR between the two groups(t=0.752 1,P=0.651 2).The results of 97 elderly patients showed that 43 strains of pathogenic bacteria were isolated from 42 positive specimens.The detection rate of gram-negative bacteria was the highest,24 strains were detected,composition ratio was 55.81%.Among them, pseudomonas aeruginosa and acinetobacter baumannii were the most detected. 18 strains of gram-positive bacteria were detected,and the composition ratio was 41.86%.The detection rate of Staphylococcus aureus was the highest.Conclusion:The TNF-α and IFN-γ can be used as a parameter to evaluate the success of the treatment,which the infection rate of Gram-negative bacteria are the highest in the pathogenic bacteria.
引文
[1]曹远国,张明艳,王琨,等.老年肺结核患者呼吸道感染病原菌分布与对干扰素γ及转录生长因子β水平的影响[J].中华医院感染学杂志,2016,26(1):87-89.
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[12]钟剑峰,盛吉芳.老年肺结核患者合并下呼吸道革兰阴性菌感染及耐药特征[J].中国微生态学杂志,2015,27(11):1309-1312.
[13]王玉美,李健,车明,等.老年肺结核患者肺部真菌感染分析[J].中华医院感染学杂志,2016,26(13):2991-2993.
[14]毛亚男,王雯,王东,等.免疫抑制剂对酵母聚糖诱导巨噬细胞Dectin-1、Toll样受体2及肿瘤坏死因子-α表达的影响[J].中国现代医学杂志,2016,26(21):13-18.
[15]刘会.不同年龄活动性肺结核患者T细胞亚群分析及s IL-2R、TNF-α动态观察[D].石家庄:河北医科大学,2015.
[16]金武,杜鹃.不同结核类型患者外周血IL-6与IL-35和IL-37及TNF-α水平的动态变化研究[J].中华医院感染学杂志,2017,27(22):5057-5060.
[17]朱磊,韩莉,鄢海燕,等.重组抗表皮生长因子疫苗P64kEGF的构建及免疫原性分析[J].细胞与分子免疫学杂志,2015,31(12):1647-1650.
[18]陈兴年,时翠林,叶志坚,等.结核性胸膜炎患者血清肿瘤坏死因子α和降钙素原的变化及其临床意义[J].结核病与肺部健康杂志,2017,6(1):47-49.
[19]钟安媛,佘由,施敏骅.非小细胞肺癌程序性死亡受体-1/程序性死亡配体-1信号通路与表皮生长因子受体相关性的研究进展[J].中华结核和呼吸杂志,2017,40(3):215-217.
[20]孟晓峰,史保中,乔鹏,等.高血压脑出血患者合并肺部感染的病原菌分布及易感因素分析[J].中华医院感染学杂志,2017,27(3):569-572.
[2]王苏娅,王仁定,田炯,等.CKD-EPI、MDRD、Cys-C方程式对老年肾脏病人e GFR计算结果调查[C].中华医学会肾脏病学分会2010学术年会,2010:28.
[3]马龙,左凯,孙丽,等.老年肺结核患者肺部感染的病原菌分析[J].中华医院感染学杂志,2016,26(16):3657-3659.
[4]袁广琴,曾谊.老年肺结核患者外周血CD4+CD8+T细胞表达水平及临床意义[J/OL].中国医学前沿杂志:电子版,2016,8(8):72-75.
[5]曹雪如.肺结核合并肺部感染患者的病原菌耐药性分析[J].国际呼吸杂志,2016,36(10):735-738.
[6]王红岩,柴文戍,李志江,等.老年肺结核合并下呼吸道感染的病原菌分布及其耐药性[J].中国老年学,2016,36(3):657-659.
[7]张琦,白亚文,刘钊,等.抗结核药物肝损害对老年肺结核患者血清TNF-α、CG及CA-199水平影响[J].实用临床医药杂志,2016,20(21):45-47.
[8]崔建娇,张莉,王萍,等.血清肿瘤坏死因子-α与免疫球蛋白E在肺结核感染患者中的表达及临床意义[J].中国老年学,2016,36(7):1651-1653.
[9]陈岚兰,庄其宏.左氧氟沙星对老年肺结核患者血清IL-6及IFN-γ水平的影响[J].中国生化药物杂志,2016,36(11):91-93.
[10]盛宇超,袁立,蒋伟利,等.肺结核患者血清Th1/Th2细胞因子浓度变化及影响因素研究[J].上海预防医学,2016,28(3):157-160.
[11]薛娜娜,刘宁,马京华,等.肺结核患者合并感染病原菌分析[J].中华医院感染学杂志,2016,26(13):2994-2996.
[12]钟剑峰,盛吉芳.老年肺结核患者合并下呼吸道革兰阴性菌感染及耐药特征[J].中国微生态学杂志,2015,27(11):1309-1312.
[13]王玉美,李健,车明,等.老年肺结核患者肺部真菌感染分析[J].中华医院感染学杂志,2016,26(13):2991-2993.
[14]毛亚男,王雯,王东,等.免疫抑制剂对酵母聚糖诱导巨噬细胞Dectin-1、Toll样受体2及肿瘤坏死因子-α表达的影响[J].中国现代医学杂志,2016,26(21):13-18.
[15]刘会.不同年龄活动性肺结核患者T细胞亚群分析及s IL-2R、TNF-α动态观察[D].石家庄:河北医科大学,2015.
[16]金武,杜鹃.不同结核类型患者外周血IL-6与IL-35和IL-37及TNF-α水平的动态变化研究[J].中华医院感染学杂志,2017,27(22):5057-5060.
[17]朱磊,韩莉,鄢海燕,等.重组抗表皮生长因子疫苗P64kEGF的构建及免疫原性分析[J].细胞与分子免疫学杂志,2015,31(12):1647-1650.
[18]陈兴年,时翠林,叶志坚,等.结核性胸膜炎患者血清肿瘤坏死因子α和降钙素原的变化及其临床意义[J].结核病与肺部健康杂志,2017,6(1):47-49.
[19]钟安媛,佘由,施敏骅.非小细胞肺癌程序性死亡受体-1/程序性死亡配体-1信号通路与表皮生长因子受体相关性的研究进展[J].中华结核和呼吸杂志,2017,40(3):215-217.
[20]孟晓峰,史保中,乔鹏,等.高血压脑出血患者合并肺部感染的病原菌分布及易感因素分析[J].中华医院感染学杂志,2017,27(3):569-572.