摘要
目的探讨术后腹腔感染对结直肠癌患者HIPPO通路基因和肠屏障及免疫功能的影响。方法选择重庆市黔江中心医院普外科2019年8月-2020年8月进行结直肠癌根治术后发生腹腔感染患者45例作为感染组,选择同期进行结直肠癌根治术术后未发生腹腔感染者45例作为对照组。对感染组病原菌分布进行调查;采集外周血,提取RNA并逆转录为cDNA后,检测HIPPO通路基因Yap、taz、mst1在mRNA上表达;常规分离血清,采用全自动血液分析仪检测血清中内毒素及D乳酸水平;抽取外周血,采用免疫磁珠法检测外周血中CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平。结果45例穿刺液或引流液培养阳性标本中共分离出病原菌48株,其中革兰阴性菌31株,占64.58%,革兰阳性菌17株,占35.42%,未分离出真菌;感染组Yap、taz、mst1 mRNA水平及内毒素、D-乳酸水平高于对照组,CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平低于对照组(P<0.05);严重腹腔感染患者Yap、taz、mst1 mRNA水平及内毒素、D-乳酸水平高于普通感染患者,CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平低于普通感染患者(P<0.05);结肠癌根治术后发生腹腔感染患者其穿刺液或引流液中Yap、taz、mst1 mRNA水平与肠屏障功能内毒素、D-乳酸水平呈正相关关系,与CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平呈负相关关系(P<0.05)。结论结直肠癌术后腹腔感染患者肠屏障功能严重受损,细胞免疫功能失衡,其机制可能与HIPPO通路相关分子上调表达有关。
OBJECTIVE To explore the effects of postoperative abdominal infection on HIPPO pathway genes,intestinal barrier and immune function in patients with colorectal cancer.METHODS 45patients with abdominal cavity infection after radical resection of colorectal cancer from Aug 2019to Aug 2020in Chongqing Qianjiang Central Hospital were selected as the infection group,and 45patients with no abdominal cavity infection after radical resection of colorectal cancer during the same period were selected as the control group.The distribution of pathogenic bacteria in the infection group was investegated;peripheral blood was collected,RNA was extracted and was reverse transcribed into cDNA,and the expression of HIPPO pathway genes yap,taz,and mst1on mRNA were detected;serum routinely separated and an automatic blood analyzer used was to detect serum endotoxin and D lactic acid level;peripheral blood was drawn,the CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)levels in the peripheral blood were detected by the immunomagnetic bead method.RESULTS A total of 48pathogenic bacteria were isolated from 45cases of puncture fluid or drainage fluid culture-positive specimens,including 31gram-negative bacteria,accounting for 64.58%,17gram-positive bacteria,accounting for 35.42%,and no fungi were isolated.Infection group Yap,Taz,mst1 mRNA levels,endotoxin,D-lactic acid levels were significantly higher than those in the control group,CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)levels were significantly lower than those in the control group(P<0.05);Yap,Taz,mst1 mRNA levels and endotoxin and D-lactic acid levels in patients with severe abdominal infection were significantly higher than the control group,CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)levels were significantly lower than ordinary infections.The results of the correlation analysis showed that the levels of Yap,Taz,mst1 mRNA in the puncture fluid or drainage fluid of patients with abdominal cavity infection after radical resection of colon cancer were significant(P<0.05).Lactic acid level was positively correlated,and CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)levels were negatively correlated(P<0.05).CONCLUSION The intestinal barrier function of patients with abdominal cavity infection after colorectal cancer surgery is severely impaired,and the cellular immune function is unbalanced.The mechanism may be related to the up-regulated expression of HIPPO pathway related molecules.
作者
刘琼
徐蓉
王琼
熊亚立
汪红英
LIU Qiong;XU Rong;WANG Qiong;XIONG Ya-li;WANG Hong-ying(Chongqing Qianjiang Central Hospital,Chongqing 409099,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第24期3772-3776,共5页
Chinese Journal of Nosocomiology
基金
重庆市黔江区科技计划基金资助项目(2019009)
关键词
结直肠癌
腹腔感染
内毒素
D乳酸
细胞免疫
HIPPO通路
Colorectal cancer
Abdominal cavity infection
Endotoxin
D lactic acid
Cellular immunity
HIPPO pathway
作者简介
通讯作者:徐蓉,E-mail:380592042@qq.com;刘琼(1982-),女,本科,主管护师,研究方向:普外科护理
