sTREM-1,Th1/Th2 cytokines and NLRP3 signal pathway in patients with open fracture of limbs combined with infection and pathogens
OBJECTIVE To investigate soluble myeloid trigger receptor 1(sTREM-1),helper T cell subpopulation 1/2(Th1/Th2)cytokines and NOD-like receptor protein 3(NLRP3)signal pathway in patients with open fracture of limbs combined with infection.METHODS A total of 102 patients with open fracture of limbs combined with in-fection(the study group)and 108 patients with open fracture of limbs without infection(the control group)ad-mitted to Yidu Central Hospital from Aug.2020 to Aug.2023 were selected,the pathogenic bacteria and drug re-sistance were analyzed.The expression of serum sTREM-1,NLRP3 and Caspase-1 in the two groups were com-pared,and the diagnostic value of serum sTREM-1,peripheral blood NLRP3 and Caspase-1 for combined infec-tions in patients with open fracture of limbs was analyzed.RESULTS The serum Th1 and Th1/Th2 of patients in the study group were(9.95±2.24)％ and 0.68±0.07,respectively,lower than those of the control group,while the serum Th2 was(14.61±4.03)％ ,higher than those of the control group(P＜0.05).In 102 patients with open fracture of limbs combined with infection,108 strains of pathogenic bacteria were detected,mainly Pseudomonas aeruginosa of gram-negative bacteria and Staphylococcus aureus of gram-positive bacteria.Pseudomonas aerugino-sa was more resistant to amicinka and gentamicin.Staphylococcus aureus was more resistant to erythromycin and penicillin.The serum levels of sTREM-1,NLRP3,and Caspase-1 in the study group were(67.68±20.97)pg/ml,2.01±0.65,and 2.12±0.69,respectively,higher than those in the control group(P＜0.05).The area under the diagnostic curve(AUC)of serum sTREM-1,peripheral blood NLRP3 and Caspase-1 combined detection was 0.945,higher than that of single detection in patients with open limb fractures combined with infection(P＜0.05),and the sensitivity and specificity of combined detection were 88.24％ and 92.59％ ,respectively.CONCLUSIONS The main pathogenic bacteria in patients with open fracture of limbs combined with infection were gram-negative bacteria,and there were differences in drug resistance among pathogens,with high resistance to commonly used antimicrobial drugs.Combined infection of open fracture of limbs was associated with high serum sTREM-1 expression and Th1/Th2 imbalance,and the NLRP3 pathway was activated.The combined detection of serum sTREM-1,peripheral blood NLRP3 and Caspase-1 was of high value in the diagnosis of combined infection of open fracture of extremities.
Open fracture of limbsInfectionPathogenic bacteriaDrug resistanceSoluble myeloid cell trigger receptor 1T helper cell subpopulation 1/2Nod-like receptor protein 3Cysteine aspartate proteinase 1
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