ABO血型与心脏外科术后深部胸骨切口感染发病时间的相关性研究

摘要

Objective To study the correlation between ABO blood group and onset time of deep sternal wound infection (DSWI) after cardiac surgical procedure. Methods The clinical materials from DSWI patients (n=84), chosen from Aviation General Hospital of China Medical University from Jan. 2012 to Dec. 2014, were retrospectively analyzed. All patients were divided, according to disease onset time, into early onset group (onset time<14 d) and late onset group (onset time≥14 d). The data was collected from the patients, and the correlation between ABO blood group and onset time of DSWI was analyzed by using multiple-Logistic regression analysis model. Results The age, male proportion, smoking rate and percentage of coronary artery bypass grafting (CABG) were higher in early onset group than those in late onset group (all P<0.05). The percentage of patients with O-type blood (46.7%) was higher in early onset group than that in late onset group (27.8%), but the difference has no statistical significance (P=0.081). After correcting age, sex, smoking, hypertension, diabetes, hyperlipidemia and initial surgery types, the results of multiple Logistic regression analysis showed that, when O-type blood was taken as reference type, the risk of late onset DSWI was higher by 8 times to 12 times in patients with A-type blood (OR=8.398, 95%CI: 1.521-46.370, P=0.015) and those with B-type blood (OR=11.913, 95%CI: 1.944-73.007, P=0.007) than that in patients with O-type blood. Conclusion The patients with A-type blood or B-type blood have higher risk of late onset DSWI when they receive cardiac surgical procedure.%目的 研究ABO血型与心脏外科术后深部胸骨切口感染(deep sternal wound infection, DSWI)发病时间的相关性.方法 回顾性分析2012年1月~2014年12月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,根据发病时间将84例DSWI患者分为2组:早发病组(发病时间<14 d)和迟发病组(发病时间≥14 d).收集患者资料,采用多元Logistic回归分析模型评价ABO血型与DSWI发病时间的相关性.结果 早发病组患者的年龄、男性比例、吸烟率及初始手术类型中冠状动脉旁路移植术比例均高于迟发组,差异均具有统计学意义(P均<0.05).虽然早发病组中O血型患者的比例(46.7%)高于迟发病组(27.8%),但差异无统计学意义(P=0.081).在校正了年龄、性别、吸烟、高血压、糖尿病、高脂血症和初始手术类型等因素后,多元Logistic回归分析结果显示:将O血型作为参照类别,A血型(OR=8.398,95%CI:1.521~46.370,P=0.015)和B血型(OR=11.913,95%CI:1.944~73.007,P=0.007)患者罹患迟发型DSWI的风险是O血型患者的8~12倍.结论 心脏外科手术患者血型为A型和B型罹患迟发型DSWI的风险增加.