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食欲减退和血清核连蛋白-1水平在烧伤创面感染患者中的作用。

The role of diminishing appetite and serum nesfatin-1 level in patients with burn wound infection.

作者信息

Albayrak Ayse, Demiryilmaz Ismail, Albayrak Yavuz, Aylu Belkiz, Ozogul Bunyami, Cerrah Serkan, Celik Muhammed

机构信息

Department of Infectious Diseases and Clinical Microbiology, Erzurum Region Education and Research Hospital, Erzurum, Turkey.

Department of General Surgery, Ibn-i Sina Hospital, Turkey.

出版信息

Iran Red Crescent Med J. 2013 May;15(5):389-92. doi: 10.5812/ircmj.4198. Epub 2013 May 5.

Abstract

BACKGROUND

The burn wound represents a susceptible site for opportunistic colonization by organisms of endogenous and exogenous origin. Diminishing appetite is known to occur in patients with burn infection, yet its underlying reason is not fully understood. We have examined the levels of nesfatin 1, a protein that we consider to be a potential new treatment target for the solution of appetite and nutrition problem in patients with burn infection.

OBJECTIVES

The aim of the present study was therefore to examine nesfatin levels in patients with burn infection.

MATERIAL AND METHODS

Laboratory values, medication and dietary records, and patient notes with diagnostic information of burn wounds patients who were admitted to the Division of Burn Treatment Center were obtained from the Erzurum Region Education and Research Hospital electronic database. Post-burn wound infection was objectively assessed by culturing wound homogenates from skin tissue. The main immediate inflammatory stress response parameters assessed were serum CRP concentrations, WBC counts, and blood nesfatin concentrations.

RESULTS

Scalding was the predominant cause of burns in both categories of patients. In 19 (61.3%) burn wound infection patients, the burns were due to a scald. A significant difference was found for the nesfatin, CRP, and WBC levels between the patients and the control group (P = 0.000). A significant difference was also determined between the nesfatin, CRP, and WBC figures at the time of hospitalization and at discharge from the hospital (P = 0.000). The most predominant bacterial isolate was Pseudomonas aeruginosa 16 (51.6%) followed by Methicilline resistant Staphylococcus aureus (MRSA) 7 (22.6%).

CONCLUSIONS

We showed that the serum nesfatin 1 level was significantly lower in the patients with burn than in the control group in our study. We considered that the central nesfatin 1 system should be taken into consideration, rather than the peripheric nesfatin 1 system, when considering the regulation of appetite in patients with burns and particularly those accompanied by infection. In other explanation of the observed negative correlation between nesfatin 1 and burn wound infection suggests that nesfatin 1 may indicate the possible contribution of nesfatin 1 to the energy homeostasis.

摘要

背景

烧伤创面是内源性和外源性微生物机会性定植的易感部位。已知烧伤感染患者会出现食欲减退,但其根本原因尚未完全明确。我们检测了一种名为nesfatin 1的蛋白质水平,我们认为它是解决烧伤感染患者食欲和营养问题的一个潜在新治疗靶点。

目的

因此,本研究旨在检测烧伤感染患者的nesfatin水平。

材料与方法

从埃尔祖鲁姆地区教育与研究医院电子数据库中获取烧伤治疗中心收治的烧伤创面患者的实验室检查值、用药及饮食记录以及带有诊断信息的患者病历。通过培养皮肤组织的创面匀浆客观评估烧伤创面感染情况。评估的主要即时炎症应激反应参数为血清CRP浓度、白细胞计数和血液nesfatin浓度。

结果

两类患者中烫伤均为烧伤的主要原因。19例(61.3%)烧伤创面感染患者的烧伤是由烫伤引起的。患者与对照组之间的nesfatin、CRP和白细胞水平存在显著差异(P = 0.000)。住院时与出院时的nesfatin、CRP和白细胞数值之间也存在显著差异(P = 0.000)。最主要的分离菌株是铜绿假单胞菌16株(51.6%),其次是耐甲氧西林金黄色葡萄球菌(MRSA)7株(22.6%)。

结论

我们的研究表明,烧伤患者血清nesfatin 1水平显著低于对照组患者。我们认为,在考虑烧伤患者尤其是伴有感染的患者的食欲调节时,应考虑中枢nesfatin 1系统而非外周nesfatin 1系统。对nesfatin 1与烧伤创面感染之间观察到的负相关的另一种解释是,nesfatin 1可能表明nesfatin 1对能量稳态的可能作用。

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