本文關(guān)鍵詞： 血流感染 降鈣素原 白細(xì)胞計(jì)數(shù) C反應(yīng)蛋白 革蘭陽(yáng)性球菌 G~+球菌 革蘭陰性桿菌 G~-桿菌 真菌　出處：《中國(guó)感染控制雜志》2017年05期 　論文類(lèi)型：期刊論文

【摘要】：目的探討聯(lián)合檢測(cè)降鈣素原(PCT)、C反應(yīng)蛋白(CRP)、白細(xì)胞(WBC)和中性粒細(xì)胞百分比(NEU%)對(duì)革蘭陽(yáng)性(G~+)球菌、革蘭陰性(G~-)桿菌及真菌所致血流感染的診斷價(jià)值。方法回顧性分析2014年1月—2015年12月某醫(yī)院389例血培養(yǎng)陽(yáng)性患者的檢測(cè)結(jié)果,根據(jù)血培養(yǎng)結(jié)果分為G~+球菌、G~-桿菌和真菌血流感染組,比較不同組別患者的炎癥指標(biāo)是否存在差異。結(jié)果經(jīng)Mann-Whitney U檢驗(yàn)顯示,G~-桿菌感染組患者血PCT高于G~+球菌、真菌感染組(G~-桿菌感染組與G~+球菌感染組比較:Z=-2.68,P0.01;G~-桿菌感染組與真菌感染組比較:Z=-2.46,P0.05)。若以PCT≥0.5 ng/mL、CRP≥5.0mg/L、NEU%≥70%及WBC≥10×109/L作為陽(yáng)性的截點(diǎn),統(tǒng)計(jì)分析顯示,G~-桿菌感染組患者血PCT陽(yáng)性率較G~+球菌、真菌感染組高(G~-桿菌感染組與G~+球菌感染組比較:χ~2=5.94,P0.05;G~-桿菌感染組與真菌感染組比較:χ~2=7.721,P0.01);G~-桿菌感染組患者血CRP陽(yáng)性率較G~+球菌感染組高(χ~2=5.03,P0.05)。用二分類(lèi)logistic回歸對(duì)四項(xiàng)指標(biāo)在鑒別G~+球菌、G~-桿菌和真菌血流感染的作用大小比較分析,僅PCT對(duì)鑒別G~-桿菌、G~+球菌和真菌有統(tǒng)計(jì)學(xué)差異(P0.01)。結(jié)論 PCT在區(qū)分血培養(yǎng)G~-桿菌、G~+球菌和真菌時(shí)有較高的準(zhǔn)確度,若能動(dòng)態(tài)監(jiān)測(cè)PCT,同時(shí)結(jié)合CRP、WBC、NEU%的結(jié)果綜合判斷,可以在血流感染早期指導(dǎo)臨床醫(yī)生快速判斷患者的病情并合理用藥,從而降低血流感染患者的病死率。
[Abstract]:Objective to investigate the combined detection of procalcitonin (PCT) C-reactive protein (CRP) and neutrophil percentage (neu) against Gram-positive cocci. The diagnostic value of blood stream infection caused by gram-negative bacilli and fungi was retrospectively analyzed in 389 patients with positive blood culture from January 2014 to December 2015 in a hospital. According to the results of blood culture, the patients were divided into two groups: group G ~ (2 +) and group of fungal blood stream infection. Results the results of Mann-Whitney U test showed that the blood PCT of the patients infected with Gladobacterium was higher than that of G ~ coccus. The fungal infection group was compared with the G ~ coccus infection group, and the control group was compared with the G ~ coccus infection group (P _ (0.01)). The ratio of PCT 鈮，

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