本文選題：細(xì)菌DNA + 膽管炎　； 參考：《重慶醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的葛西手術(shù)后膽管炎是膽道閉鎖患兒行葛西手術(shù)治療后一常見且較為嚴(yán)重的術(shù)后并發(fā)癥。本研究通過檢測患兒血清中的細(xì)菌DNA來研究葛西手術(shù)后并發(fā)膽管炎患兒細(xì)菌DNA的檢測率以及與之相關(guān)的臨床因素。方法通過對110例接受葛西手術(shù)患兒的橫向研究,110例患兒中包括77例術(shù)后并發(fā)膽管炎患兒以及33例術(shù)后未并發(fā)膽管炎患兒。血液樣本在取得患兒家屬同意的情況下采集或門診隨訪復(fù)查時采集。通過PCR技術(shù)檢測細(xì)菌DNA,并通過DNA核苷酸測序來確定細(xì)菌的菌屬。結(jié)果對于血清中細(xì)菌的檢測16SrDNA檢測方法較血培養(yǎng)方法靈敏(58.4%vs 14.3%,p0.0001);術(shù)后并發(fā)膽管炎組較術(shù)后未并發(fā)膽管炎組的血清細(xì)菌DNA檢測率明顯增加(58.4%vs 39.4%,p=0.095)。血清中的16SrDNA主要來源于腸道內(nèi)的機(jī)會致病菌,包括大腸埃希氏菌,肺炎克雷伯桿菌,志賀氏菌,腸桿菌菌屬。益生菌治療或抗生素應(yīng)用能部分降低血清中細(xì)菌DNA水平。兒童終末期肝病模型評分,血清PCT水平,血清CRP水平,心率與細(xì)菌DNA檢測率相關(guān)。結(jié)論患兒血清中檢測到的細(xì)菌DNA同腸道內(nèi)的細(xì)菌DNA類似,并且術(shù)后并發(fā)膽管炎組較術(shù)后未并發(fā)膽管炎組以及對照組血清更常檢測到細(xì)菌DNA。這些結(jié)果均表明16SrDNA檢測技術(shù)可用于葛西手術(shù)后并發(fā)膽管炎以及其他感染的早期診斷。
[Abstract]:Objective: cholangitis after Gesi operation is a common and serious postoperative complication in children with biliary atresia. The purpose of this study was to study the detection rate of bacterial DNA in children with cholangitis after Gesi operation and its clinical factors by detecting bacterial DNA in serum of children with cholangitis. Methods A transverse study was conducted in 110 children with cholangitis and 33 children without cholangitis after operation. Blood samples were collected with the consent of the child's family or during outpatient follow-up. The bacterial DNA was detected by PCR and the genus of bacteria was determined by DNA nucleotide sequencing. Results the detection of bacteria in serum by 16SrDNA method was more sensitive than that by blood culture method (58.4 vs 14.3), and the detection rate of serum bacterial DNA in postoperative complicated cholangitis group was significantly higher than that in non-postoperative cholangitis group (58.4 vs 39.4%). 16SrDNA in serum is mainly derived from opportunistic bacteria in the intestine, including Escherichia coli, Klebsiella pneumoniae, Shigella and Enterobacter spp. Probiotics therapy or antibiotic use can partially reduce the level of bacterial DNA in serum. The model score, serum PCT level, serum CRP level and heart rate were correlated with bacterial DNA detection rate in children with end-stage liver disease. Conclusion bacterial DNA detected in serum of children is similar to bacterial DNA in intestinal tract, and bacterial DNA is more frequently detected in serum of children with cholangitis after operation than that with cholangitis after operation and without cholangitis after operation. These results suggest that 16SrDNA can be used in the early diagnosis of cholangitis and other infections after Gesi's operation.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R726.5

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本文編號：1855429