癫痫患者感染的病原学特点及对血清热休克蛋白与胶质纤维酸性蛋白的影响

发布时间：2018-10-21 15:59

【摘要】：目的探讨癫痫患者并发感染的病原菌分布、耐药性及其对血清热休克蛋白与胶质纤维酸性蛋白的影响。方法选取2012年1月-2016年12月医院收治的难治性癫痫持续状态合并感染的246例患者为观察组,另外选取同期收治的癫痫未发生感染患者202例为对照组,采集感染部位标本进行病原菌鉴定和药敏试验;采集空腹血检测热休克蛋白(HSP)和胶质纤维酸性蛋白(GFAP)。结果观察组患者中以呼吸道感染为主,共193例占78.46%;共检出230株病原菌,以革兰阴性菌为主,共137株占59.57%;鲍氏不动杆菌和铜绿假单胞菌均对左氧氟沙星、氯霉素、米诺环素、阿米卡星、氨曲南、头孢哌酮/舒巴坦耐药率较低,均10.00%;观察组血清HSP-70、HSP-90和GFAP水平显著高于对照组(P0.05)。结论呼吸道感染是癫痫患者最易发生的医院感染类型,其中革兰阴性菌是主要病原菌;感染可导致癫痫患者血清HSP和GFAP表达水平上升。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria, drug resistance and their effects on serum heat shock protein (HSP) and glial fibrillary acidic protein (GFAP) in patients with epilepsy. Methods from January 2012 to December 2016, 246 patients with refractory status epilepticus complicated with infection were selected as the observation group, and 202 patients with no infection of epilepsy were selected as the control group. The pathogen identification and drug sensitivity test were carried out in infected site samples. Fasting blood samples were collected to detect heat shock protein (HSP) and glial fibrillary acidic protein (GFAP). Results in the observation group, respiratory tract infection was predominant, 193 cases accounted for 78.46%, 230 strains of pathogenic bacteria were detected, 137 strains of Gram-negative bacteria accounted for 59.57 strains, Acinetobacter baumannii and Pseudomonas aeruginosa were treated with levofloxacin, chloramphenicol, minocycline, The drug resistance rate of amikacin, aztreonam, cefoperazone / sulbactam was low, and the levels of serum HSP-70,HSP-90 and GFAP in the observation group were significantly higher than those in the control group (P0.05). Conclusion Respiratory tract infection is the most susceptible type of nosocomial infection in epileptic patients, among which Gram-negative bacteria are the main pathogens, and the expression of HSP and GFAP in serum of epileptic patients can be increased by infection.
【作者单位】：广西中医药大学第一附属医院脑病科二区;中国人民解放军第三0三医院神经内科;广西医科大学第一附属医院神经内科;
【基金】：广西壮族自治区卫生厅自筹经费课题(Z2014364)
【分类号】：R742.1

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