本文選題：銅綠假單胞菌　切入點(diǎn)：髓樣細(xì)胞觸發(fā)受體　出處：《瀘州醫(yī)學(xué)院》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過研究髓樣細(xì)胞觸發(fā)受體-1(triggering receptor expressed onmyeloid cells-1，TREM-1) mRNA及血清sTREM-1在銅綠假單胞菌(Pseudomonas aeruginosa, PA)呼吸系統(tǒng)感染和定植不同狀態(tài)下的表達(dá)水平的變化，探討TREM-1與銅綠假單胞菌肺炎及呼吸道定植的相關(guān)性，從而為在病原學(xué)培養(yǎng)中病原菌為定植菌抑或致病菌的判斷提供理論及實(shí)驗(yàn)依據(jù)、更好的早期感染預(yù)警、反應(yīng)臨床預(yù)后判斷及指導(dǎo)抗生素的使用。方法：1.將SD大鼠按隨機(jī)原則分成肺部感染組、口咽部定植組及對(duì)照組。環(huán)甲膜穿刺注入銅綠假單胞菌（PA）菌液建立大鼠肺炎模型，定植組則由大鼠口、鼻腔內(nèi)注入PA菌液，并將環(huán)甲膜穿刺注入無菌生理鹽水作為對(duì)照，并于建模后第3、9、24小時(shí)分別隨機(jī)抽取并予以處死后收集標(biāo)本。2.收集各組不同時(shí)間點(diǎn)處死的大鼠血液，以ELISA法檢測(cè)血清中sTREM-1、CRP和PCT的水平；采用PCR法檢測(cè)肺組織中TREM-1mRNA的表達(dá)水平；肺組織病理切片比較炎癥的范圍及程度，同時(shí)行肺組織勻漿菌落計(jì)數(shù)，定植組加行咽拭子細(xì)菌培養(yǎng)。3.應(yīng)用SPSS軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析，數(shù)據(jù)采用X+S表示。組間比較采用單因素方差分析，sTREM-1與CRP、PCT線性相關(guān)采用Pearson相關(guān)分析。結(jié)果：1.感染組各時(shí)間點(diǎn)大鼠肺組織中TREM-1mRNA的表達(dá)水平較定植組及對(duì)照組均有明顯的增高，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05），其中細(xì)菌接種3小時(shí)后TREM-1mRNA的表達(dá)就有升高，9小時(shí)達(dá)到高峰，24小時(shí)開始回落。定植組與對(duì)照組TREM-1mRNA表達(dá)比較沒有顯著差異。2.感染組各時(shí)間點(diǎn)大鼠血清中sTREM-1、CRP和PCT的水平較定植組及對(duì)照組均有明顯的增高，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。其中sTREM-1、CRP及PCT水平在3小時(shí)開始上升，9小時(shí)升高到峰值，24小時(shí)后下降。相關(guān)性分析中sTREM-1和CRP、PCT均成正相關(guān)，相關(guān)系數(shù)分別為0.86和0.75。3.感染組大鼠肺組織病理改變?cè)?小時(shí)最為嚴(yán)重，，炎癥范圍廣，程度重，3、24小時(shí)與之相比均較輕，而定植組和對(duì)照組的肺泡及肺間質(zhì)結(jié)構(gòu)基本正常，無明顯出血、炎細(xì)胞浸潤(rùn)；感染組肺組織均培養(yǎng)出銅綠假單胞菌，肺組織勻漿菌落計(jì)數(shù)均105CFU/g，定植組和對(duì)照組肺組織均未培養(yǎng)出細(xì)菌，定植組咽拭子細(xì)菌培養(yǎng)均有呼吸道正常菌群及銅綠假單胞菌生長(zhǎng)。結(jié)論：1.銅綠假單胞菌肺部感染其肺組織TREM-1mRNA和血清sTREM-1表達(dá)明顯增高，且與咽部定植和對(duì)照組存在明顯差異。TREM-1及sTREM-1的檢測(cè)有助于銅綠假單胞菌感染與定植的鑒別。 2.銅綠假單胞菌肺部感染肺組織TREM-1mRNA和血清sTREM-1表達(dá)水平與肺部炎癥的程度有關(guān)，TREM-1的檢測(cè)對(duì)感染性疾病預(yù)后判斷有指導(dǎo)意義。3.銅綠假單胞菌肺炎血清sTREM-1和炎癥指標(biāo)CRP，PCT水平變化呈高度正相關(guān)，sTREM-1在銅綠假單胞菌感染中有重要意義。
[Abstract]:Objective: to study the changes of the expression levels of mRNA and serum sTREM-1 in Pseudomonas aeruginosa (PAA) in different respiratory infection and colonization conditions by using the myeloid cell trigger receptor expressed onmyeloid cells-1tREM-1 (TREM-1) mRNA, a myeloid cell trigger receptor, and to investigate the changes of the expression level of sTREM-1 in different respiratory system infection and colonization of Pseudomonas aeruginosa (PAA). To explore the correlation between TREM-1 and pneumonia and respiratory tract colonization of Pseudomonas aeruginosa, so as to provide a theoretical and experimental basis for the identification of pathogenic bacteria as colonizing bacteria or pathogenic bacteria in etiological culture, and to provide a better early warning of infection. Methods Sprague-Dawley rats were randomly divided into three groups: pulmonary infection group, oropharyngeal colonization group and control group. In the colonization group, PA bacteria were injected into the nasal cavity of the rats, and the cyclidine puncture was injected into the sterile saline as the control group. The blood samples of rats were collected at different time points to detect the levels of serum sTREM-1CRP and PCT by ELISA method, and the expression of TREM-1mRNA in lung tissue by PCR method. The range and degree of inflammation were compared by pathological section of lung tissue, and the colony count of lung tissue homogenate was carried out, and the bacterial culture of pharynx swab was added to the colonization group. The data were analyzed by SPSS software. The data were expressed by X S. The linear correlation between TREM-1 and CRPP-PCT was analyzed by univariate ANOVA and Pearson correlation analysis. Results: 1. The expression of TREM-1mRNA in lung tissue of infected rats was significantly higher than that of colonized group and control group at each time point. The difference was statistically significant (P < 0.05), in which the expression of TREM-1mRNA increased at 3 hours after inoculation and reached its peak at 9 hours and began to decrease at 24 hours. There was no significant difference in TREM-1mRNA expression between the colonized group and the control group. 2.The expression of TREM-1mRNA in the infected rats at different time points was not significantly different from that in the control group. The levels of serum sTREM-1CRP and PCT were significantly higher than those in the colonized group and the control group. The difference was significant (P < 0.05). The levels of sTREM-1CRP and PCT began to rise at 3 hours and then increased to a peak at 9 hours and then decreased after 24 hours. There was a positive correlation between sTREM-1 and sTREM-1 in correlation analysis. The correlation coefficients were 0.86 and 0.75.3, respectively. The pathological changes of lung tissue in the infected group were the most serious at 9 hours, with a wide range of inflammation. The lung interstitial structure of the colonized group and the control group was basically normal, compared with the control group for 24 hours. Pseudomonas aeruginosa was cultured in the lung tissue of the infected group, the colony count of the homogenate of the lung tissue was 105 CFU / g, and the bacteria were not cultured in the lung tissue of the colonization group and the control group. In the colonized group, the normal bacterial flora and the growth of Pseudomonas aeruginosa were found in the respiratory tract. Conclusion: 1. The expression of TREM-1mRNA and serum sTREM-1 in pulmonary infection of Pseudomonas aeruginosa was significantly increased. The detection of TREM-1 and sTREM-1 was helpful for the identification of Pseudomonas aeruginosa infection and colonization. 2. The expression of TREM-1mRNA and serum sTREM-1 in pulmonary tissue of Pseudomonas aeruginosa pulmonary infection is related to the degree of pulmonary inflammation. The detection of TREM-1 has guiding significance in judging the prognosis of infectious disease .3.The serum sTREM-1 and the inflammatory index of Pseudomonas aeruginosa pneumonia. The level change of TREM-1 is highly positively correlated with the infection of Pseudomonas aeruginosa (Pseudomonas aeruginosa).
【學(xué)位授予單位】：瀘州醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R378

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