脊柱术后感染的病原学分析及红细胞免疫水平检测

The etiological characteristics and detection of levels of erythrocyte immune function in patients with an infection after spinal surgery

目的分析脊柱术后感染的病原学特征,并检测患者红细胞免疫水平变化,探讨其临床意义。 方法收集2015年12月-2017年12月本院收治的脊柱术后发生感染的患者40例为感染组,脊柱术后未感染者40例为未感染组,同一时期在本院体检的健康志愿者40例为对照组。利用全自动微生物鉴定系统分析感染组患者感染病原菌的分布特征;采用郭峰法对3组患者进行红细胞免疫水平检测。 结果感染组40例脊柱术后感染患者共分离出病原菌51株,其中革兰阴性菌28株(54.90%),以铜绿假单胞菌(12株)和大肠埃希菌(10株)为主;革兰阳性菌21株,占41.18%,以金黄色葡萄球菌(11株)和屎肠球菌(5株)为主;真菌2株,占3.92%。检测FEER、ATER、DTER、RBC-C3bR,感染组分别为(45.54±4.89)%、(51.36±5.27)%、(25.39±2.72)%、(12.76±1.46)%,未感染组分别为(53.56±5.44)%、(63.12±6.81)%、(32.08±3.90)%、(16.02±2.02)%,与对照组(62.15±6.31)%、(69.29±7.05)%、(39.67±4.85)%、(19.95±2.36)%比较差异均有统计学意义(P<0.05);感染组与未感染组比较差异均有统计学意义(P<0.05)。 结论脊柱术后感染病原菌分布广泛,主要为革兰阴性菌,以铜绿假单胞菌为主。脊柱术后感染患者红细胞免疫水平明显下降,治疗时应重视观察上述指标的变化。

Objectives To analyze the etiological characteristics of patients with an infection after spinal surgery and to detect changes in levels of erythrocyte immune function and explore their clinical significance. Methods Forty patients who developed an infection after spinal surgery at this Hospital from December 2015to December 2017served as patients with an infection,and 40patients without an infection after spinal surgery served as patients without an infection.Forty healthy volunteers seen at this Hospital during the same period served as the control group.Characteristics of pathogen distribution in patients with an infection were analyzed using an automated microbiological identification system;the levels of erythrocyte immune function in the three groups were measured using the method of Guo et al. Results A total of 51 strains of pathogens were isolated from 40patients with an infection following spinal surgery,including 28strains of Gram-negative bacteria(54.90%)that were mainly Pseudomonas aeruginosa (12strains)and Escherichia coli (10 strains),21strains of Gram-positive bacteria(41.18%)that were mainly Staphylococcus aureus(11strains)and Enterococcus faecium (5strains),and 2strains of fungi.(3.92%).FEER,ATER,DTER,and RBC-C3bR were determined and were 45.54±4.89%,51.36±5.27%,25.39±2.72%,and 12.76±1.46%in patients with an infection and 53.56 ±5.44%,63.12±6.81%,32.08±3.90%,and 16.02±2.02%in patients without an infection.FEER,ATER,DTER, and RBC-C3bR were 62.15±6.31%,69.29±7.05%,39.67±4.85%,and 19.95±2.36%in the control group. FEER,ATER,DTER,and RBC-C3bR in patients with an infection and patients without an infection differed significantly from FEER,ATER,DTER,and RBC-C3bR in the control group(P<0.05).FEER,ATER,DTER,and RBC-C3bR differed significantly in patients with an infection and patients without an infection(P<0.05). Conclusion A wide range of pathogens caused an infection after spinal surgery;those pathogens were mainly Gram-negative bacteria,the most prevalent of which was Pseudomonas aeruginosa.The levels of erythrocyte immune function decreased significantly in patients with an infection after spinal surgery,and changes in the aforementioned indices should be observed during treatment.