中国真菌学杂志2025，Vol.20Issue(1)：28-33,6.
四肢骨折患者术后感染的病原菌分布及血清TIRAP、CD34、SDF-1α的变化
Distribution of pathogens and changes in serum TIRAP,CD34,and SDF-1α levels in postoperative infections in patients with limb fractures
摘要
Abstract
Objective To investigate the distribution of pathogens in postoperative infections patients with limb fractures,and the predictive value of serum Toll/interleukin-1 receptor associated protein(TIRAP),CD34,and stromal cell-derived factor-1α(SDF-1α)for infections.Methods A total of 104 limb fractures patients with postoperative infection treated in our hospital between August 2021 and February 2024 were regarded as the infection group,while 104 limb fractures patients without postoperative infection during the same period were selected as the control group.The samples from the incision/wound secretions of infected patients were subjected to pathogen isolation and identification.ELISA method was applied to detect serum TIRAP,CD34,and SDF-1α levels.Logistic regression was applied to analyze the influencing factors of postoperative infection in patients with limb fractures.ROC curve was applied to analyze the predictive value of indicators for infection.Z-test was applied to compare AUC.Pearson method was applied to analyze the correlation between different variables.Results A total of 136 pathogenic bacteria were isolated from 104 infected patients,including 46 strains of Gram positive bacteria(33.82%),57 strains of Gram negative bacteria(41.91%),and 33 strains of Candida(24.27%).The serum TIRAP level,TNF-α,CRP and the proportion of diabetes patients in the infection group were higher than those in the control group on the third day after operation,while the levels of CD34 and SDF-1α were lower than those in the control group(P<0.05).TIRAP(OR=2.910)was an independent risk factor for postoperative infection in patients with limb fractures,while CD34(OR=0.745)and SDF-1α(OR=0.802)were protective factors for postoperative infection in patients with limb fractures(P<0.05).The AUC of TIRAP,CD34,and SDF-1α alone in predicting postoperative infection in patients with limb fractures was lower than the AUC of the three combination(Z=3.984,3.059,3.351,P<0.05).The wound healing time and wound healing score of the infection group were higher than those of the control group(P<0.05).The serum TIRAP level in the infection group was positively correlated with wound healing time and wound healing score,while CD34 and SDF-1α levels were negatively correlated with wound healing time and wound healing score(P<0.05).Conclusion Postoperative infections in patients with limb fractures are mainly caused by Staphylococcus aureus,Pseudomonas aeruginosa,and Candida albicans.Serum TIRAP level in infected patients increases,while CD34 and SDF-1α levels decrease.The expression of various indicators is closely related to healing.关键词
四肢骨折/感染/病原菌/Toll/白介素-1受体相关蛋白/CD34/基质细胞衍生因子-1αKey words
limb fractures/incision infection/pathogenic bacteria/Toll/interleukin-1 receptor related protein/CD34/stromal cell-derived factor-1α分类
医药卫生引用本文复制引用
胡迎华,郑冲,卢伟杰..四肢骨折患者术后感染的病原菌分布及血清TIRAP、CD34、SDF-1α的变化[J].中国真菌学杂志,2025,20(1):28-33,6.基金项目
广州市科技计划项目(K2022010103) （K2022010103）
