剖宫产术后切口感染患者外周血sTREM-1、TNF-α、白细胞介素-8表达及对免疫应答的影响

Expression of sTREM-1,TNF-α,and Interleukin-8 in Peripheral Blood of Patients with Incision Infection after Cesarean Section and Its Effect on Immune Response

目的探究剖宫产术后切口感染患者外周血可溶性髓样细胞触发受体-1、肿瘤坏死因子-α、白细胞介素-8表达及对免疫应答的影响。方法选取某院2018年1月1日-2019年8月31日剖宫产术后切口感染患者47例作为研究组,另选同期剖宫产术后未发生切口感染者128例作为对照组。检测对比2组外周血sTREM-1、TNF-α、IL-8及免疫应答指标水平,分析上述外周血指标诊断剖宫产术后切口感染的价值及其与免疫应答相关性。结果研究组术后4天外周血sTREM-1、TNF-α、IL-8水平达到峰值,术后2天、4天、6天均高于对照组;术后4天外周血sTREM-1、TNF-α、IL-8中,TNF-α单独诊断剖宫产术后切口感染的曲线下面积大于sTREM-1、IL-8,为0.810,最佳诊断敏感度为65.96%,特异度为90.62%,3种指标联合诊断的AUC为0.880,最佳诊断敏感度为74.47%,特异度为90.62%;研究组术后2天、4天、6天外周血FEER低于对照组,FEIR高于对照组;外周血sTREM-1、TNF-α、IL-8与FEER存在负相关关系,与FEIR存在正相关关系。结论剖宫产术后切口感染患者外周血s TREM-1、TNF-α、IL-8水平呈异常高表达状态,于术后4天达到峰值,在诊断切口感染方面具有重要价值,且与机体免疫应答具有密切相关性,可为临床诊治剖宫产术后切口感染提供重要参考依据。

Objectives To investigate the expression of soluble myeloid cell triggering receptor-1,tumor necrosis factor-α,and interleukin-8 in peripheral blood of patients with incision infection after cesarean section and the effect on immune response.Methods Forty-seven patients with incisional infection after cesarean section in a hospital from January 1 st,2018 to August 31st,2019 were selected as the study group,another 128 patients who did not develop wound infection after cesarean section were selected as the control group.The levels of peripheral blood sTREM-1,TNF-α,IL-8 and immune response indexes were detected and compared between the two groups.The value of the above peripheral blood indexes in diagnosing wound infection after cesarean section and its correlation with immune response were analyzed.Results The levels of sTREM-1,TNF-α,and IL-8 in the peripheral blood of the study group reached the peak on the fourth days after the operation,and the second,fourth,and sixth days after operation were higher than those in the control group.Among the sTREM-1,TNF-α,and IL-8 in peripheral blood at fourth days after surgery,the area under the curve for the diagnosis of incisional infection after cesarean section alone was greater than that of sTREM-1 and IL-8,which was 0.810,the best diagnostic sensitivity was 65.96%,the specificity was 90.62%.The AUC of the three indicators combined diagnosis was 0.880,the best diagnostic sensitivity was 74.47%,and the specificity was 90.62%.The FEER of peripheral blood was lower than that of the control group,and the FEIR was higher than that of the control group at the second,fourth,and sixth days after operation.There was a negative correlation between sTREM-1,TNF-α,IL-8 and FEER in peripheral blood,and a positive correlation with FEIR.Conclusions The levels of s TREM-1,TNF-α and IL-8 in peripheral blood of patients with incision infection after cesarean section were abnormally high,it reached a peak at fourth days after surgery,which was of great value in the diagnosis of incision infection,it was closely related to the immune response of the body,which could provide an important reference for clinical diagnosis and treatment of incision infection after cesarean section.