目的 探讨心脏外科术后深部胸骨切口感染(DSWI)患者ABO血型分布的临床意义.方法 回顾性分析2012—2014年中国医科大学航空总医院心胸外科84例心脏手术后DSWI患者的临床资料,根据ABO血型分为4组:A血型组、B血型组、AB血型组和O血型组,按血型是否为A型分为A血型组和非A血型组,分析DSWI患者ABO血型的分布情况,并比较不同ABO 血型组DSWI患者的危险因素、临床表现及病原学特点.结果 DSWI患者中A血型组33例(39.3％),非A血型组51例(60.7％)[其中B血型组16例(19.1％),O血型组29例(34.5％),AB血型组6例(7.1％)];DSWI患者中A血型的比例高于正常人群,但差异无统计学意义(P= 0.055).比较不同血型组DSWI患者的基线特征分布及各种临床表现的发生率,差异均无统计学意义(均P＞ 0.05).但与非A血型组或与其他各ABO血型组比较,A血型组DSWI患者白细胞(WBC)计数升高的发生率高,差异有统计学意义(P＜0.05).与非A血型组或其他ABO血型组比较,A血型组革兰阳性菌检出率高,差异有统计学意义(P＜0.05).此外,B血型组仅检出铜绿假单胞菌3株,而AB血型组未检出革兰阴性菌.结论 ABO血型可能在心脏外科手术后DSWI的发病机制中发挥着一定作用,而这种作用可能与某种特定的细菌感染相关.%Objective To explore the clinical significance of distribution of ABO blood group in patients with deep sternal wound infection(DSWI)after cardiac surgery.Methods Clinical data of 84 patients with DSWI after cardiac surgery in the department of cardiothoracic surgery in General Hospital of China Aviation of China Medical University in 2012-2014 were analyzed retrospectively, according to ABO blood group, patients were divided into 4 groups:A blood group, B blood group, AB blood group, and O blood group, according to whether the blood group was A group, they were divided into A blood group and non-A blood group.Distribution of ABO blood group in DSWI patients was analyzed, risk factors, clinical manifestations, and etiological characteristics of DSWI patients with different ABO blood groups were compared.Results Among patients with DSWI, A blood group and non-A blood group were 33 cases(39.3％)and 51 cases(60.7％)respectively(B, O, and AB blood group were 16 cases[19.1％], 29 cases[34.5％], and 6 cases[7.1％]respectively);the proportion of A blood group in DSWI patients was higher than that of the healthy population, but the difference was not statistically significant(P=0.055). Distribution of baseline characteristics and incidences of various clinical manifestations among DSWI patients of different blood groups were not statistically significant(all P＞0.05).However, compared with non-A blood group or other ABO blood groups, DSWI patients with A blood group had higher incidence of elevated white blood cell count, difference was statistically significant(P＜0.05), positive detection rate of gram-positive bacteria in A blood group was also higher, difference was statistically significant(P＜0.05).In addition, only 3 strains of Pseudomonas aeruginosa was detected only in B blood group, while gram-negative bacteria were not detected in AB blood group. Conclusion ABO blood group may play a role in the pathogenesis of DSWI after cardiac surgery, which may be associated with a specific bacterial infection.
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