慢性骨髓炎感染病原菌及ESR、CCL11、BMP-2的诊断价值

Distribution of pathogens isolated from patients with chronic osteomyelitis and diagnostic values of ESR,CCL11 and BMP-2

目的分析慢性骨髓炎感染病原菌分布特点及血沉(ESR)、CC修饰趋化因子11(CCL11)、骨形态发生蛋白-2(BMP-2)的诊断价值。方法将2020年5月-2023年1月厦门大学附属第一医院收治的70例慢性骨髓炎患者作为病例组,同期选取76名在厦门大学附属第一医院进行体检的健康体检者作为健康对照组,分析慢性骨髓炎患者感染病原菌分布特点,采用受试者工作特征(ROC)曲线分析ESR、CCL11、BMP-2对慢性骨髓炎的诊断价值。结果70例慢性骨髓炎患者共检出79株病原菌,主要为铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、表皮葡萄球菌,占比分别为15.19%、13.92%、27.85%、13.92%;病例组ESR、CCL11水平高于健康对照组,BMP-2水平低于健康对照组(P<0.05),ESR、CCL11、BMP-2联合诊断慢性骨髓炎的曲线下面积(AUC)为0.899,敏感度和特异度分别为91.43%和75.00%。结论慢性骨髓炎患者主要感染病原菌种类为铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、表皮葡萄球菌,外周血ESR、CCL11、BMP-2水平异常表达,三者联合检测诊断价值较高。

OBJECTIVE To investigate the distribution of pathogens isolated from the patients with chronic osteo-myelitis and analyze the diagnostic values of erythrocyte sedimentation rate(ESR),CC-modified chemokine 11(CCL11)and bone morphogenetic protein-2(BMP-2).METHODS A total of 70 patients with chronic osteomyeli-tis who were treated in the First Affiliated Hospital of Xiamen University from May 2020 to Jan 2023 were as-signed as the case group,meanwhile,76 healthy people who received physical examination in the hospital were chosen as the control group.The distribution of pathogens isolated from the chronic osteomyelitis patients was ob-served,and the values of ESR,CCL11 and BMP-2 in diagnosis of chronic osteomyelitis were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Totally 79 strains of pathogens were isolated from the 70 patients with chronic osteomyelitis;Pseudomonas aeruginosa,Klebsiella pneumoniae,Staphylococcus aureus and Staphylococcus epidermidis were the predominant species of pathogens,accounting for 15.19%,13.92%,27.85%and 13.92%,respectively.The levels of ESR and CCL11 of the case group were higher than those of the health control group,while the BMP-2 level of the case group was lower than that of the health control group(P<0.05).The area under curve(AUC)of the joint detection of ESR,CCL11 and BMP-2 was 0.899 in diagnosis of chronic osteomyelitis,with the sensitivity 91.43%,the specificity 75.00%.CONCLUSION P.aeruginosa,K.pneumoniae,S.aureus and S.epidermidis are dominant among the pathogens isolated from the patients with chronic osteomyelitis.The patients present with abnormal expressions of peripheral blood ESR,CCL11 and BMP-2,and the joint detection of the three indexes has high diagnostic values.