肾结石术后尿路感染Wnt/β-catenin通路基因和MMP-7表达

Expression of Wnt/β-catenin pathway gene and MMP-7 in renal stone patients with postoperative urinary tract infection

目的探讨肾结石术后尿路感染Wnt/β-catenin通路基因和基质金属蛋白-7(MMP-7)的表达。方法选择儋州市人民医院泌尿外科2018年1月-2020年1月收治肾结石经皮肾镜取石术(PCNL)术后尿路感染患者62例作为感染组,同期医院肾结石PCNL术后未发生尿路感染的患者60例作为非感染组。采用实时荧光定量聚合酶链式法对两组患者外周血Wnt/β-catenin通路基因Wnt1、β-catenin相对表达水平进行检测,采用酶联免疫吸附法检测患者尿中MMP-7水平,分析尿MMP-7对于肾结石术后尿路感染的诊断价值。结果62例尿液标本共检出病原菌60株,其中革兰阴性菌42株,占70.00%,革兰阳性菌16株,占26.67%,真菌2株,占3.33%,大肠埃希菌检出率最高,共26株,占43.33%;感染组血液Wnt-1、β-catenin在mRNA上的相对表达及尿MMP-7表达水平高于非感染组(P<0.05);重度感染组Wnt-1、β-catenin、MMP-7水平高于中度感染组及轻度感染组,中度感染组Wnt-1、β-catenin、MMP-7水平高于轻度感染组(P<0.05);受试者工作特征曲线(ROC)分析结果表明,尿中MMP-7水平对于肾结石患者术后尿路感染诊断曲线下面积为0.773,P=0.002。结论肾结石术后尿路感染以大肠埃希菌为主,病原可能通过Wnt/β-catenin通路及MMP-7通路引发感染,尿MMP-7水平对其具有良好的诊断价值。

OBJECTIVE To explore the expression of Wnt/β-catenin pathway gene and MMP-7 in renal stone patients with postoperative urinary tract infection.METHODS Totally 62 kidney stone patients who underwent percutaneous nephrolithotomy(PCNL)and had postoperative urinary tract infection in Danzhou People’s Hospital from Jan 2018 to Jan 2020 were assigned as the infection group,meanwhile,60 kidney stone patients who underwent PCNL but did not have postoperative urinary tract infection were set as the non-infection group.The relative expression levels of Wnt/β-catenin pathway genes Wnt1 andβ-catenin in peripheral blood were detected by means of real-time fluorescent quantitative polymerase chain amplification reaction,the urine MMP-7 level was determined with the use of enzyme-linked immunosorbent assay,and the value of urine MMP-7 in diagnosis of postoperative urinary tract infection was analyzed.RESULTS A total of 60 strains of pathogens were isolated from 62 urine specimens,42(70.00%)of which were gram-negative bacteria,16(26.67%)were gram-positive bacteria,and 2(3.33%)were fungi.The isolation rate of Escherichia coli was the highest(26 strains in total,43.33%).The relative expression levels of mRNA of blood Wnt-1 andβ-catenin and urine MMP-7 level of the infection group were significantly higher than those of the non-infection group(P<0.05).The levels of Wnt-1,β-catenin and MMP-7 of the severe infection group were significantly higher than those of the moderate infection group and the mild infection group,and the levels of Wnt-1,β-catenin and MMP-7 of the moderate infection group were significantly higher than those of the mild infection group(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under curve of the urine MMP-7 was 0.773 in diagnosis of postoperative urinary tract infection in the kidney stone patients(P=0.002).CONCLUSION E.coli is the predominant species of pathogen causing the postoperative urinary tract infection in the kidney stone patients,the pathogens may induce the infection through Wnt/β-catenin pathway and MMP-7 pathway,and the urine MMP-7 has high value in diagnosis of the infection.