恶性血液病造血干细胞移植后感染病原菌分布及对BCL-2、BAX蛋白表达的影响

发布时间：2018-08-07 17:10

【摘要】：目的:探讨恶性血液病患者外周血造血干细胞移植术后感染病原菌分布及对BCL-2、BAX蛋白表达的影响。方法:对2011年1月-2015年12月在弋矶山医院及省立医院血液科行造血干细胞移植的64例恶性血液病患者的临床资料进行分析,按照术后是否感染分为感染组(36例)和非感染组(28例),对造血干细胞移植后感染病原菌进行菌型鉴定,并对两组患者外周血T淋巴细胞亚群、C-反应蛋白(C-reaction protein,CRP)水平及血清细胞凋亡蛋白表达进行测定。结果:36例恶性血液病患者经造血干细胞移植后,从感染患者分离出病原菌共36株,其中革兰阴性菌24株(66.67%)且以肺炎克雷伯杆菌(19.44%)为主,感染组患者外周血中CD4+水平(t=2.637,P0.01)、CD4+/CD8+比值(t=8.223,P0.01)、BCL-2蛋白表达(t=5.852,P0.01)、BCL-2/BAX比值(t=14.56,P0.01)均显著低于非感染组,而感染组CD8+表达(t=2.285,P0.01)、CRP水平(t=39.71,P0.01)和BAX蛋白表达水平均高于非感染组。Pearson相关性检验分析发现,感染组患者CD4+/CD8+比值与BCL-2/BAX比值呈正相关(r=0.341,P0.05),血清CRP水平与BCL-2/BAX比值呈负相关(r=-0.362,P0.05)。结论:恶性血液病患者外周血造血干细胞移植术后感染病原菌以革兰阴性菌为主,术后感染能够促进相关炎症因子和凋亡蛋白表达的上调,病原菌可能也参与细胞凋亡过程。
[Abstract]:Objective: to investigate the distribution of pathogenic bacteria of peripheral blood stem cell transplantation (PBSCT) in patients with malignant hematologic diseases and its effect on the expression of BCL-2 and BAX protein. Methods: the clinical data of 64 cases of hematopoietic stem cell transplantation from January 2011 to December 2015 in Hematology Department of Geji Mountain Hospital and Provincial Hospital were analyzed. Infection was divided into infection group (36 cases) and non-infection group (28 cases) according to whether infection after operation. The pathogenic bacteria of infection after hematopoietic stem cell transplantation (HSCT) were identified. The level of C-reactive protein (C-reaction) and the expression of serum apoptotic protein in peripheral blood T lymphocyte subsets of the two groups were measured. Results after hematopoietic stem cell transplantation, 36 strains of pathogenic bacteria were isolated from infected patients, among which 24 strains (66.67%) were Gram-negative bacteria and 19.44% were Klebsiella pneumoniae. The level of CD4 in peripheral blood of infected patients was significantly lower than that of non-infected patients (ttn2.637 / P0.01), and the expression of BCL-2 protein (tn5.852 / P0.01) and the ratio of BCL-2 / BAX (tnr14.56% P0.01) were significantly lower in infected group than in non-infected group, while the levels of CD8 and BAX in infected group were significantly higher than those in non-infected group (t 2.285 P0.01) and BAX protein levels were significantly higher than those in non-infected group by Pearson correlation test, and the expression of BCL-2 protein and BAX protein in infected group were significantly higher than those in non-infection group (P < 0.01), but the expression of BCL-2 protein and BAX protein in infected group were significantly higher than those in non-infection group (P < 0.01). There was a positive correlation between CD4 / CD8 ratio and BCL-2/BAX ratio in infected group (r = 0.341), and a negative correlation between serum CRP level and BCL-2/BAX ratio (r ~ (-0.362) P _ (0.05). Conclusion: Gram-negative bacteria are the main pathogens of peripheral blood stem cell transplantation in patients with malignant hematologic diseases. Infection after operation can promote the up-regulation of the expression of related inflammatory factors and apoptotic proteins, and the pathogenic bacteria may also participate in the process of apoptosis.
【作者单位】：安徽皖南医学院弋矶山医院血液科;安徽省立医院血液科;
【基金】：安徽省芜湖市科技惠民重大项目(2013hm40)
【分类号】：R457.7;R733

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