肛周坏死性筋膜炎患者的感染病原菌与淋巴细胞亚群变化情况

摘要/Abstract

摘要： 目的探讨肛周坏死性筋膜炎患者的感染病原菌与淋巴细胞亚群变化情况。方法选取2022年1月—2022年12月在北京市昌平区中西医结合医院确诊为肛周坏死性筋膜炎的98例患者作为研究对象,所有患者给予感染相关微生物检测与手术治疗,观察预后情况。调查所有患者的一般资料,检测淋巴细胞亚群变化情况并进行相关性分析。结果所有患者都检出感染相关微生物,其中革兰氏阳性菌54例,革兰氏阴性菌39例,真菌5例,主要微生物为溶血葡萄球菌、大肠埃希菌、屎肠球菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌等。所有患者都顺利完成治疗,发生并发症12例,死亡9例（死亡组）,并发症发生率与病死率分别为12.24%和9.18%。死亡患者的CD3⁺T细胞、CD8⁺T细胞、NK细胞等比例均显著高于生存患者,B淋巴细胞比例显著低于生存患者（P<0.05）。Spearman相关分析显示,肛周坏死性筋膜炎患者死亡与CD3⁺T细胞、CD8⁺T细胞、NK细胞等比例都呈正相关,与B淋巴细胞比例呈负相关（P<0.05）。二分类Logistic回归分析显示,CD3⁺T细胞比例、CD8⁺T细胞比例、NK细胞比例为导致患者死亡的主要因素（P<0.05）。结论肛周坏死性筋膜炎患者的感染微生物主要为溶血葡萄球菌、大肠埃希菌、屎肠球菌等,治疗后并发症发生率与病死率依然比较高,淋巴细胞亚群变化与患者预后具有相关性。

关键词: 肛周坏死性筋膜炎, 感染微生物, 溶血葡萄球菌, 相关性

Abstract: Objective To discuss the changes of infectious pathogens and lymphocyte subsets in patients with perianal necrotizing fasciitis. Methods From January 2022 to December 2022, 98 cases of patients with perianal necrotizing fasciitis diagnosed in a certain hospital were selected as the study subjects. All patients were given infection related microbial detection and surgical treatment, and the prognosis were observed. Investigated the general information of all patients, Detected and correlation analyzed of changes in lymphocyte subsets. Results Infection-related microorganisms were detected in all patients, included 54 cases of gram-positive bacteria, 39 cases of gram-negative bacteria and 5 cases of fungi. The main microorganisms were Staphylococcus haemolyticus, Escherichia coli, Enterococcus faecium, Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa. All patients were successfully completed the treatment, with 12 cases of complications and 9 cases of deaths (death group). The incidence rates of complications and mortality were 12.24% and 9.18% respectively. The proportion of CD3⁺T cells, CD8⁺T cells and NK cells in dead patients were significantly higher than that in living patients, while the proportion of B lymphocytes were significantly lower than that in living patients (P<0.05). Spearman correlation analysis showed that the death of patients with perianal necrotizing fasciitis were positively correlated with the proportion of CD3⁺T cells, CD8⁺T cells and NK cells, and were negatively correlated with the proportion of B lymphocytes (P<0.05). Logistic regression analysis showed that the proportion of CD3⁺T cells, CD8⁺T cells and NK cells were the main factors leading to the death of patients (P<0.05). Conclusion The infection microorganism of patients with perianal necrotizing fasciitis are mainly Staphylococcus haemolyticus, Escherichia coli and Enterococcus faecium. The incidence of complications and mortality after treatment are still relatively high. The changes of lymphocyte subsets are correlated with the prognosis of patients.

Key words: perianal necrotizing fasciitis, infectious microorganism, staphylococcus haemolyticus, relevance

中图分类号:

R446

蒋子轩. 肛周坏死性筋膜炎患者的感染病原菌与淋巴细胞亚群变化情况[J]. 中华养生保健, 2023, 41(19): 46-49.

JIANG Zi-xuan. Changes of Infectious Pathogens and Iymphocyte Subsets in Patients with Perianal Necrotizing Fasciitis[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(19): 46-49.

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