目的 探讨血清高迁移率族蛋白B1(high mobility group protein B1,HMGB1)、Toll样受体-2(Toll like receptor-2,TLR-2)水平变化在胫腓骨骨折术后感染中的临床价值.方法 回顾性选取2022年1月—2024年1月期间本院手术的339例胫腓骨骨折患者为研究对象,统计病原菌感染情况,根据患者住院期间所有部位感染情况分为感染组52例和未感染组287例.采用ELISA法检测术后第1天和术后第3天血清HMGB1、TLR-2水平;logistics回归分析筛选影响胫腓骨骨折术后感染的因素;ROC曲线分析术后第3天血清HMGB1、TLR-2水平对胫腓骨骨折术后感染的预测价值.结果 52例感染患者中共分离出病原菌86株,其中大肠埃希菌占比最多(37.21％),其次为白念珠菌(24.42％)、金黄色葡萄球菌(10.46％).术后分离出的86株病原菌主要来自于手术部位分泌物(74.42％),其次为血液(12.79％).感染组术后第3天血清HMGB1、TLR-2水平及糖尿病、受伤至手术时间≥3 h、手术时间≥1.5 h患者比例高于未感染组(P<0.05).术后第3天血清HMGB1(OR=2.979)、TLR-2(OR=3.014)是胫腓骨骨折术后感染的独立危险因素(P<0.05).术后第3天血清HMGB1、TLR-2预测单独及联合预测胫腓骨骨折术后感染的AUC为0.838、0.811、0.906.结论 胫腓骨骨折术后感染的主要病原菌为大肠埃希菌、白念珠菌,监测血清HMGB1、TLR-2水平变化可有效预测胫腓骨骨折术后感染.
Changes and clinical significance of serum HMGB1 and TLR-2 levels in patients with postoperative infection of tibiofibular fractures
Objective To explore the clinical value of changes in serum high mobility group protein B1 (HMGB1) and Toll like receptor-2 (TLR-2) levels in postoperative infection of tibiofibular fractures.Methods This study retrospectively select-ed 339 patients with tibiofibular fractures who underwent surgery in our hospital from January 2022 to January 2024 as sub-jects.The pathogen ofinfection was statistically analyzed,and the patients were dividedinto an infected group(52 cases)and an uninfected group (287 cases) based on their infection situation of all parts during hospitalization.ELISA method was ap-plied to detect serum HMGB1 and TLR-2 levels on the 1st and 3rd postoperative days.Logistic regression analysis was ap-plied to screen for factors affecting postoperative infection in tibiofibular fractures.ROC curve was applied to analyze the pre-dictive value of serum HMGB1 and TLR-2 levels on postoperative infection of tibiofibular fractures on the 3rd day after sur-gery.Results A total of 86 pathogenic strainswere isolated from 52 infected patients,with Escherichia coli accounting for the highest proportion (37.21％),followed by Candida albicans (24.42％) and Staphylococcus aureus (10.46％).The 86 strains of pathogens isolated after surgery mainly came from surgical site secretions (74.42％),followed by blood (12.79％).The levels of serum HMGB1 and TLR-2 on the 3rd day after operation,and the proportions of diabetes,injury to operation time ≥ 3 h,operation time ≥ 1.5 h in the infected group were higher than those in the uninfected group (P<0.05).Serum HMGB1 (OR=2.979) and TLR-2 (OR=3.014) on the third day after surgery were independent risk factors for postopera-tive infection in tibiofibular fractures (P<0.05).The AUCs of serum HMGB1 and TLR-2 on the third day after surgery predicted separately and in combination in postoperative infection of tibiofibular fractures were0.838,0.811,and 0.906.Conclusion The main pathogens causing postoperative infections in tibiofibular fractures were Escherichia coli and Candida albicans.Monitoring changes in serum HMGB1 and TLR-2 levels couldeffectively predict postoperative infections in tibiofib-ular fractures.
tibiofibular fracturesinfectionhigh mobility group protein B1Toll like receptor-2
万方数据
维普
