剖宫产术后感染产妇炎症因子和T淋巴细胞亚群及Hippo信号通路基因水平

Inflammatory factors,T lymphocyte subsets and Hippo signaling pathway genes of cesarean section puerpera with postoperative infection

目的分析剖宫产术后感染产妇炎症因子和T淋巴细胞亚群水平变化及对Hippo信号通路的影响。方法纳入2020年9月-2022年9月于河南省生殖妇产医院、河南省妇幼保健院就诊的剖宫产术后感染产妇158例和术后未感染产妇173例,分别纳入感染组与非感染组,分析剖宫产术后感染病原菌分布及对炎症因子和T淋巴细胞亚群及Hippo信号通路基因水平的影响。结果158例剖宫产术后感染产妇共分离出病原菌171株,其中革兰阴性菌118株,革兰阳性菌44株,真菌9株,占比分别为69.01%、25.73%、5.26%;与非感染组比较,感染组血清白细胞介素(IL)-1β、IL-2、IL-6、肿瘤坏死因子-α(TNF-α)、可溶性髓系细胞触发受体-1(sTREM-1)水平及外周血Hippo信号通路基因哺乳动物不育系20样激酶1(mst1)、Tafazzin蛋白(taz)、Yes相关蛋白(yap)表达水平均升高(P<0.05),外周血CD_(3)^(+)、CD_(4)^(+)、CD_(3)^(+)CD_(8)^(+)水平降低(P<0.05);与普通感染产妇比较,严重感染产妇血清IL-1β、IL-2、IL-6、TNF-α、sTREM-1水平与外周血Hippo信号通路基因mst1、taz、yap表达水平更高(P<0.05),外周血CD_(3)^(+)、CD_(4)^(+)、CD_(3)^(+)CD_(8)^(+)水平更低(P<0.05)。结论剖宫产术后感染病原菌以革兰阴性菌为主,感染可导致血清IL-1β、IL-2、IL-6、TNF-α、sTREM-1及外周血Hippo信号通路基因mst1、taz、yap表达水平升高,外周血CD_(3)^(+)、CD_(4)^(+)、CD_(3)^(+)CD_(8)^(+)水平降低。

OBJECTIVE To observe the impact of changes of inflammatory factors and T lymphocyte subsets on Hippo signaling pathways of the cesarean section puerpera with postoperative infection.METHODS A total of 158 cesarean section puerpera with postoperative infection and 173 puerpera without postoperative infection who were treated in Henan Reproductive and Maternity Hospital and Henan Maternal and Child Health Hospital from Sep 2020 to Sep 2022 were enrolled in the study and were respectively assigned as the infection group and the non-infection group.The distribution of pathogens isolated from the puerpera with postoperative infection and the influence on inflammatory factors,T lymphocyte subsets and Hippo signaling pathway genes were observed.RESULTS Totally 171 strains of pathogens were isolated from the 158 cesarean section puerpera with postoperative infection,118(69.01%)of which were gram-negative bacteria,44(25.73%)were gram-positive bacteria,and 9(5.26%)were fungi.The levels of serum interleukin(IL)-1β,IL-2,IL-6,tumor necrosis factor-α(TNF-α)and soluble triggering receptor expressed on myeloid cells(sTREM-1)as well as the expression levels of peripheral blood Hippo signaling pathway genes mammalian sterile 20 like kinase 1(mst1),tafazzin protein(taz)and Yes-associated protein(yap)were significantly higher in the infection group than in the non-infection group(P<0.05);the levels of peripheral blood CD_(3)^(+),CD_(4)^(+)and CD_(3)^(+)CD_(8)^(+)of the infection group were significantly lower than those of the non-infection group(P<0.05).The levels of serum IL-1β,IL-2,IL-6,TNF-αand sTREM-1 as well as the expression levels of peripheral blood Hippo signaling pathway genes mst1,taz and yap were significantly higher in the puerpera with severe infection than in the puerpera with common infection(P<0.05);the levels of peripheral blood CD_(3)^(+),CD_(4)^(+)and CD_(3)^(+)CD_(8)^(+)of the puerpera with severe infection were significantly lower than those of the puerpera with common infection(P<0.05).CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the cesarean section puerpera with postoperative infection.The infection may lead to the rise of serum IL-1β,IL-2,IL-6,TNF-α,sTREM-1,peripheral blood Hippo signaling pathway genes mst1,taz and yap and the decline of peripheral blood CD_(3)^(+),CD_(4)^(+)and CD_(3)^(+)CD_(8)^(+).