老年患者胃切除消化道重建病原菌感染及对细胞外基质降解与重构的影响研究

Impact of pathogenic bacteria infections on degradation and recombination of extracellular matrix of elderly patients undergoing reconstruction of alimentary tract after gastrectomy

目的对胃切除消化道重建老年患者病原菌感染分布及感染对细胞外基质降解与重构的影响进行研究,为临床治疗提供参考。方法对医院2011年5月-2014年5月诊治的150例胃切除消化道重建病原菌感染老年患者进行研究,分析病原菌的分布及感染后对基质金属蛋白酶表达的影响;以医院同期胃切除消化道重建未感染患者180例为未感染组,同期老年健康体检者150名为对照组;对比3组受试人员血清中MMP1、MMP2、MMP3和MMP9水平变化及PGI、PGII和G-17蛋白水平变化;采用SPSS20.0软件进行统计分析。结果 150例老年胃切除消化道重建病原菌感染患者中分离病原菌150株,其中革兰阳性菌77株占51.3%,革兰阴性菌73株占48.7%;感染患者血清中MMP1、MMP2、MMP3和MMP9水平明显升高(P<0.05),PGI、PGII和G-17蛋白水平明显降低,差异均有统计学意义(P<0.05)。结论老年胃切除消化道重建患者易受到病原菌感染,且感染后基质金属蛋白酶表达上调,而血清胃蛋白酶和胃泌素水平明显降低。

OBJECTIVE To investigate the distribution of pathogenic bacteria infections in elderly patients undergoing reconstruction of alimentary tract after gastrectomy and observe the impact of the infections on degradation and recombination of extracellular matrix so as to provide guidance for clinical treatment.METHODS A total of 150 elderly patients with pathogenic bacteria infections who underwent the reconstruction of alimentary tract after gastrectomy from May 2011 to May 2014 were enrolled in the study,and the distribution of pathogens and the impact of the infections on expression of matrix metalloproteinases（MMPs）were observed.During the same period,180 patients without infections who underwent the reconstruction of alimentary tract after gastrectomy were chosen as the non-infection group,and 150 healthy elderly people who received the physical examination were set as the control group.The levels of serum MMP1,MMP2,MMP3,and MMP9 as well as the levels of PGI,PGII,and G-17 proteins were observed and compared among the three groups of participants;the statistical analysis was performed with the use of SPSS20.0software.RESULTS A total of 150 strains of pathogenic bacteria were isolated from 150 elderly patients with pathogenic bacteria infections who underwent the reconstruction of alimentary tract after gastrectomy,including 77（51.3%）strains of gram-positive bacteria and 73（48.7%）strains of gram-negative bacteria.The levels of serum MMP1,MMP2,MMP3,and MMP9 of the patients with infections were significantly elevated（P〈0.05）,the levels of PGI,PGII,and G-17 proteins were significantly reduced,and there was significant difference（P〈0.05）.CONCLUSION The elderly patients undergoing the reconstruction of alimentary tract after gastrectomy are at high risk of pathogenic bacteria infections,the expression of MMPs is up-regulated after they have the infections,however,the levels of serum pepsin and gastrin are significantly reduced.