肝衰竭患者人工肝置留管感染的病原学分布特征与相关细胞因子水平变化分析

目的研究与观察肝衰竭患者人工肝置留管感染的病原学分布特征与相关细胞因子水平的变化情况。方法选取2014年1月至2016年12月期间本地区的85例肝衰竭人工肝置留管感染患者为观察组，同时期未发生留置管感染的85例患者为对照组，将观察组的病原菌分布情况进行分析及比较，同时将对照组和观察组的相关细胞因子水平进行比较，并对观察组中不同病原菌感染患者的相关细胞因子水平进行比较，并以Logistic回归分析处理相关细胞因子与人工肝置留管感染的关系。结果观察组共检出80株病原菌，其中革兰阳性球菌的检出率高于革兰阳性杆菌、革兰阴性球菌及真菌（P〈0．05），观察组的相关细胞因子水平高于对照组（P〈0．05），观察组中不同病原菌感染者的相关细胞因子水平无显著差异（P〉0．05），而不同感染程度患者的相关细胞因子水平存在显著性差异（P〈0．05），Logistic归分析显示，上述相关细胞因子均与人工肝置留管感染有密切的关系（P〈0．05）。结论肝衰竭患者人工肝置留管感染的病原菌主要为革兰阳性球菌，且此类患者的相关细胞因子水平较高，应针对患者此类情况进行针对性干预。

Objective To study and observe the pathogenic distribution characteristics of artificial liver indwelling drain infection of patients with hepatic failure and change situation of related cytokines levels. Methods 85 patients with hepatic failure and artificial liver indwelling drain infection in our district from January 2014 to December 2016 were selected as the observation group, 85 patients without indwelling drain infection were selected as the control group, then the pathogenic distribution situation of observation group were analyzed and compared, and the related cytokines levels of control group and observation group were compared, the related cytokines levels of observation group with different pathogenic infection and infection degree were compared, then the relationship between the related cytokines and artificial liver indwelling drain infection were analyzed by the Logistic regression analysis. Results 80 pathogenic bacteria were detected from 85 patients with infection in observation group, the detection rates of Gram-positive cocci were higher than those of Gram-positive bacilli, Gram negative cocci and fungi （ P〈0.05 ） , and the related cytokines levels of observation group were all higher than those of control group （ P〈0.05 ） , the related cytokines levels of observation group with different pathogenic infection had no significant differences （ P〉0.05 ） , while the related cytokines levels of observation group with different infection degree had significant differences （ P〈0.05 ） , the Logistic regression analysis showed that those related cytokines all had close relationship to the artificial liver indwelling drain infection （ P〈0.05 ） . Conclusion The main pathogenic bacteria of artificial liver indwelling drain infection of patients with hepatic failure is Gram-positive cocci, and the related cytokines levels of these patients are higher, so the situation of these patients should be paid to targeted intervention.