脑外伤患者术后颅内感染病原菌分析与对一氧化氮及降钙素原水平影响研究

Pathogen distribution and effect on serum NO and PCT concentration in cerebral trauma patients with postoperative intracranial infection

目的对脑外伤患者术后感染病原菌进行分析,同时观察对一氧化氮(NO)和降钙素原(PCT)水平的影响,为临床疾病治疗提供借鉴。方法对医院2010年6月-2015年6月诊治的260例脑外伤术后感染患者进行研究,采用PhoenixTM100全自动微生物鉴定系统对病原菌进行鉴定分型;设医院同期健康体检者130名为对照组;同期住院130例脑外伤未感染患者为未感染组;采用酶联免疫吸附测定法测定研究对象血清中NO、内皮素、内皮型一氧化氮合酶(Enos)及PCT、脑源性神经营养生长因子(BNDF)和核转录因子Κb(NFκB)蛋白水平的变化。结果 260例感染患者共分离病原菌260株,革兰阳性菌129株占49.6%,以肺炎链球菌和酿脓链球菌为主,革兰阴性菌131株占50.4%,以肺炎克雷伯菌和鲍氏不动杆菌为主;与对照组和未感染组患者相比,感染组患者血清中NO、内皮素、eNOS及NFκB水平明显升高,BNDF水平明显降低,差异均有统计学意义(P<0.01)。结论脑外伤术后患者容易受到病原菌感染,且能上调血清中NO、内皮素、eNOS及PCT和NFκB、下调BNDF水平。

OBJECTIVE To explore the pathogen distribution and the effect on NO and PCT concentration in cerebral trauma patients with postoperative infection so as to provide reference for clinical treatment.METHODS Totally 260 cases of cerebral trauma patients in our hospital from Jun.2010 to Jun.2015 were enrolled in this research.The isolated pathogens were identified by PhoenixTM100Compact2 and the serum cytokine concentrations including NO,endothelin,eNOS,PCT,BNDF and NFκB were detected by ELISA.Another 130 cases of healthy subjects and 130 cases of non-infected cerebral trauma patients were taken as controls.RESULTS Totally 260 stains of pathogens were isolated from the 260 patients.The pathogens included 129（49.6%）gram-positive strains dominated by Streptococcus pneumoniae and Streptococcus pyogenes,and 131（50.4%）gram-negative strains dominated by Klebsiella pneumoniae and Acinetobacter baumannii.The results also revealed that the serum NO,endothelin,PCT,eNOS and NFκB were increased greatly（P〈0.01）while the BNDF level was decreased greatly（P〈0.01）when compared with controls.CONCLUSIONCerebral trauma patients are suffered to pathogen infection,leading to increased serum NO,eNOS,PCT,endothelin and NFκB and decreased BNDF.