糖尿病足感染患者病原菌及血清APN、IL-17表达与感染程度的相关性

目的探究糖尿病足(Diabetic foot,DF)感染患者病原菌分布及血清脂联素(Adiponectin,APN)、白细胞介素-17(Interleukin-17,IL-17)表达与感染程度的相关性。方法选取2018年1月-2019年12月河北医科大学第四医院收治的227例DF患者,其中107例感染患者为感染组,120例为未感染组,另选取120名健康体检者为对照组。比较三组研究对象血清APN、IL-17表达水平,分析感染组创口分泌物病原菌分布,分析血清APN、IL-17表达水平与感染程度的相关性。结果 107例感染患者共分离出病原菌113株,其中革兰阳性菌53株(46.90%),革兰阴性菌47株(41.59%),真菌13株(11.50%);三组血清APN水平比较,感染组低于未感染组和对照组,未感染组低于对照组(P<0.05);血清IL-17水平比较,感染组高于未感染组和对照组,未感染组高于对照组(P<0.05);不同感染程度患者血清IL-17水平轻度感染低于中度感染和重度感染,中度感染低于重度感染(P<0.05);血清APN水平轻度感染高于中度感染和重度感染,中度感染高于重度感染(P<0.05);DF感染患者感染程度与血清APN呈负相关,与血清IL-17呈正相关(P<0.05)。结论 DF感染以革兰阳性菌为主,且随着感染程度加重,患者血清IL-17表达水平逐渐升高,血清APN表达逐渐降低。

Distribution of pathogens isolated from patients with diabetic foot infection and correlation between serum APN,IL-17 and degree of infection

OBJECTIVE To explore the distribution of pathogens isolated from the patients with diabetic foot(DF)infection and analyze the correlation between serum adiponectin(APN)and interleukin-17(IL-17)and the degree of infection.METHODS A total of 227 patients with DF who were treated in the Fourth Hospital of Hebei Medical University from Jan 2018 to Dec 2019 were enrolled in the study,107 of whom had infection and were assigned as the infection group,and 120 were assigned as the non-infection group,meanwhile,120 healthy people who received physical examination were set as the control group.The levels of APN and IL-17 were compared among the three groups of study subjects,the distribution of pathogens isolated from wound secretions of the patients with infection was observed,and the correlation between the levels of serum APB,IL-17 and the degree of infection was analyzed.RESULTS Totally 113 strains of pathogens were isolated from the 107 patients with infection,53(46.90%)of which were gram-positive bacteria,47(41.59%)of which were gram-negative bacteria,and 13(11.50%)were fungi.The APN level of the infection group was significantly lower than that of the non-infection group and the control group,and the APN level of the non-infection group was lower than that of the control group(P<0.05).The serum IL-17 level of the infection group was significantly higher than that of the non-infection group and the control group,and the serum IL-17 level of the non-infection group was significantly higher than that of the control group(P<0.05).The serum IL-17 level of the patients with mild infection was significantly lower than that of the patients with moderate or severe infection,and the serum IL-17 level of the patients with moderate infection was significantly lower than that of the patients with severe infection(P<0.05).The serum APN level of the patients with mild infection was significantly higher than that of the patients with moderate or severe infection,and the serum APN level of the patients with moderate infection was significantly higher than that of the patients with severe infection(P<0.05).The degree of infection of the DF patients was negatively correlated with the serum APN and positively correlated with the serum IL-17(P<0.05).CONCLUSION The gram-positive bacteria are dominant among the pathogens isolated from the patients with DF infection.With the aggravation of infection,the serum IL-17 level is elevated,and the serum APN is reduced.