摘要
通过单因素及多因素方法 ,分析 12 8只体表面积 30 %Ⅲ度烫伤大鼠肠源性细菌移位与肠道机械屏障、生物屏障、免疫屏障相关的 7项指标间的关系。结果显示 ,烫伤后细菌移位率为 5 3 9% (6 9/ 12 8)。单因素分析发现细菌移位组血浆内毒素和IL 6水平、回盲部膜菌群中大肠杆菌和真菌数、回肠损伤评分显著增高 (P =0 0 0 0~0 0 0 5 ) ,肠粘液sIgA、膜菌群中双歧杆菌量显著减少 (P =0 0 0 0 )。多元logistic逐步回归发现回肠损伤评分和回盲部膜菌群中双歧杆菌量是烫伤后细菌移位发生的独立危险因素 ,其相对危险度分别为 4 5 5 2(P =0 0 0 1)和 0 0 39(P =0 0 11)。该研究表明 ,肠道粘膜屏障功能和肠菌群中双歧杆菌量为肠源性细菌移位发生的独立预测因素。
The current study was conducted to analyze the risk factors associated with the development of intestinal bacterial translocation in rats following major burns. Wistar rats were subjected to 30% total body surface area skin full thickness thermal injury, and samples were collected on postburn days 1, 3, and 5. Univariate analysis and multivariate logistic regression analysis were performed to evaluate the correlations among intestinal mucosal barrier, biological barrier and immunologic barrier associated with gut derived bacterial translocation. The results showed that the total bacterial translocation rate was 53 9% (69 in 128) after burns. According to univariate analysis, the levels of plasma endotoxin and interleukin 6, the counts of mucosal fungi and E. coli, and the score of intestinal lesion markedly increased in animals with bacterial translocation compared with those without ( P =0 000~0 005). But intestinal mucus sIgA and the mucosal bifidobacteria count were significantly reduced in animals with bacterial translocation compared with those without ( P =0 000). Multivariate logistic regression revealed that intestinal lesion scores (odds ratio 45 52, 95% confidence interval 5 25~394 80) and the counts of mucosal bifidobacteria (OR 0 039, 95% CI 0 0032~0 48) were independent predictors associated with gut derived bacterial translocation secondary to severe burns. These results suggested that the increase in intestinal lesion score and decrease in bifidobacteria count in mucosal flora were independent risk factors related to bacterial translocation, and specific interventions targeting these high risk factors should be instituted to attenuate gut derived bacterial translocation.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2002年第9期770-773,共4页
Medical Journal of Chinese People's Liberation Army
基金
国家重点基础研究发展规划项目 (编号G1 9990 542 0 3)
军队杰出中青年人才专项基金 (编号 98J0 1 3)资助课题
关键词
烧伤
细菌移位
因素分析
统计学
burns
bacterial translocation
factor analysis, statistical