血清PCT对革兰阴性菌感染脓毒症患者的诊断效果研究(1)
【摘要】 目的：探討血清PCT对革兰阴性(G-)菌感染脓毒症患者的诊断效果。方法：回顾性分析2015年5月-2017年11月在本院接受治疗的脓毒症患者53例的临床资料。按革兰染色分为G+菌组和G-菌组；按感染G-菌种类分为大肠埃希菌组、鲍曼不动杆菌组、肺炎克雷伯杆菌组、铜绿假单胞菌组、其他G-菌组；按感染部位分为肺部组、腹腔组、泌尿系统组、其他部位组。比较G+菌和G-菌组白细胞、CRP、PCT水平；将大肠埃希菌组分别与鲍曼不动杆菌组、肺炎克雷伯杆菌组、铜绿假单胞菌组、其他G-菌组PCT水平进行比较；将肺部组分别与腹腔组、泌尿系统组、其他部位组PCT水平进行比较，并对PCT比较差异有意义的感染部位组进行不同菌种感染所占例数比较。结果：G+菌感染14例，G-菌感染39例(大肠埃希菌感染17例，鲍曼不动杆菌感染9例，肺炎克雷伯杆菌6例，铜绿假单胞菌4例，其他G-菌感染3例；肺部感染21例，泌尿系统感染8例，腹部感染7例，其他部位感染3例)。G+菌和G-菌组白细胞、CRP水平比较，差异均无统计学意义(P>0.05)；G-菌组PCT水平明显高于G+菌组(P<0.05)；大肠埃希菌组血清PCT水平高于鲍曼不动杆菌组(P<0.05)，但与其他组比较差异无统计学意义(P>0.05)；肺部组PCT水平低于泌尿系统组(P<0.05)，但与其他部位比较差异均无统计学意义(P>0.05)；泌尿系统组感染大肠埃希菌占比高于肺部组，感染鲍曼不动杆菌占比低于肺部组，比较差异均有统计学意义(P<0.05)；泌尿系统组与肺部组感染的其他G-菌种比较差异无统计学意义(P>0.05)。结论：血清PCT可作为G-菌感染脓毒症患者的诊断依据，并以此诊断感染G-菌种和感染部位。
【关键词】 脓毒症； PCT； 革兰阴性菌； 诊断
【Abstract】 Objective：To investigate the diagnostic value of serum PCT in sepsis patients with Gram-negative bacteria infection.Method：The clinical data of 53 patients with sepsis treated in our hospital from May 2015 to November 2017 were retrospectively analyzed.According to Gram stain，they were divided into G+ bacteria group and G- bacteria group，according to the G- bacteria type of infection，the G- bacteria group were divided into Escherichia coli group，Acinetobacter baumannii group，Klebsiella pneumoniae group，Pseudomonas aeruginosa group and other G- bacteria group；according to the site of infection，the G- bacteria group were divided into lung group，intraperitoneal group，urinary system group and other groups.The levels of leukocyte，CRP and PCT in G+ and G- bacteria groups were compared，PCT levels in Escherichia coli were compared with those of Acinetobacter baumannii，Klebsiella pneumoniae，Pseudomonas aeruginosa and other G-bacteria groups.PCT levels in lung group were compared with those of abdominal cavity group，urinary system group，and other sites respectively，and PCT comparison of the infection sites with significant difference，the number of different strains infected were compared.Result：14 cases of G+ bacteria infection and 39 cases of G- bacteria infection (17 cases of Escherichia coli infection，9 cases of Acinetobacter Bauman infection，6 cases of Klebsiella pneumoniae，4 cases of Pseudomonas aeruginosa，3 cases of other G- bacteria infection；21 cases of pulmonary infection，8 cases of urinary system infection，7 cases of abdominal infection，3 infection in other parts).The levels of leukocyte and CRP in G+ and G- bacteria groups were compared，the differences were not statistically significant(P>0.05)；the PCT level in G- bacteria group was significantly higher than that of G+ bacteria group(P<0.05).The PCT level of Escherichia coli group was higher than that of others (P<0.05)，but compared with other bacterial groups，the differences were not statistically significant(P>0.05).The PCT level in lung group was lower than that of urinary system group(P<0.05)，but compared with other parts，the differences were not statistically significant(P>0.05).The infection rate of Escherichia coli in urinary system group was higher than that of lung group，and the proportion of Acinetobacter infection in Bauman group was lower than that of lung group，the differences were statistically significant(P<0.05)，the other G- bacteria in urinary system and lung group were compared，the difference was not statistically significant(P>0.05).Conclusion：Serum PCT can be used as a diagnostic basis for sepsis patients infected with G- bacteria，and can be used to diagnose G- bacteria infection and infection sites., 百拇医药(李伟露)
【关键词】 脓毒症； PCT； 革兰阴性菌； 诊断
【Abstract】 Objective：To investigate the diagnostic value of serum PCT in sepsis patients with Gram-negative bacteria infection.Method：The clinical data of 53 patients with sepsis treated in our hospital from May 2015 to November 2017 were retrospectively analyzed.According to Gram stain，they were divided into G+ bacteria group and G- bacteria group，according to the G- bacteria type of infection，the G- bacteria group were divided into Escherichia coli group，Acinetobacter baumannii group，Klebsiella pneumoniae group，Pseudomonas aeruginosa group and other G- bacteria group；according to the site of infection，the G- bacteria group were divided into lung group，intraperitoneal group，urinary system group and other groups.The levels of leukocyte，CRP and PCT in G+ and G- bacteria groups were compared，PCT levels in Escherichia coli were compared with those of Acinetobacter baumannii，Klebsiella pneumoniae，Pseudomonas aeruginosa and other G-bacteria groups.PCT levels in lung group were compared with those of abdominal cavity group，urinary system group，and other sites respectively，and PCT comparison of the infection sites with significant difference，the number of different strains infected were compared.Result：14 cases of G+ bacteria infection and 39 cases of G- bacteria infection (17 cases of Escherichia coli infection，9 cases of Acinetobacter Bauman infection，6 cases of Klebsiella pneumoniae，4 cases of Pseudomonas aeruginosa，3 cases of other G- bacteria infection；21 cases of pulmonary infection，8 cases of urinary system infection，7 cases of abdominal infection，3 infection in other parts).The levels of leukocyte and CRP in G+ and G- bacteria groups were compared，the differences were not statistically significant(P>0.05)；the PCT level in G- bacteria group was significantly higher than that of G+ bacteria group(P<0.05).The PCT level of Escherichia coli group was higher than that of others (P<0.05)，but compared with other bacterial groups，the differences were not statistically significant(P>0.05).The PCT level in lung group was lower than that of urinary system group(P<0.05)，but compared with other parts，the differences were not statistically significant(P>0.05).The infection rate of Escherichia coli in urinary system group was higher than that of lung group，and the proportion of Acinetobacter infection in Bauman group was lower than that of lung group，the differences were statistically significant(P<0.05)，the other G- bacteria in urinary system and lung group were compared，the difference was not statistically significant(P>0.05).Conclusion：Serum PCT can be used as a diagnostic basis for sepsis patients infected with G- bacteria，and can be used to diagnose G- bacteria infection and infection sites., 百拇医药(李伟露)