本文選題：上呼吸道感染　切入點：病原菌分布　出處：《中華醫(yī)院感染學(xué)雜志》2017年17期

【摘要】：目的分析小兒上呼吸道感染病原菌分布及血清炎癥因子改變的意義,為臨床診療提供參考。方法選擇2015年6月-2016年6月在醫(yī)院兒科接受就診的小兒上呼吸道感染患兒87例作為觀察組,另納入健康對照組80例;使用吸痰器采集觀察組患兒呼吸道分泌物進行病原菌鑒定;同時比較兩組兒童的血清炎癥因子水平,并使用ROC曲線分析相關(guān)指標(biāo)對小兒上呼吸道感染的診斷價值。結(jié)果觀察組患兒共分離致病菌109株,其中革蘭陰性菌71株占65.14%,革蘭陽性菌38株占34.86%,排名前5位的病原菌依次為流感嗜血桿菌、肺炎鏈球菌、大腸埃希菌、金黃色葡萄球菌、肺炎克雷伯菌;觀察組患兒與對照組兒童血清炎癥因子CRP(16.8±6.7VS5.6±3.2;t=13.59,P0.01)、TNF-α(22.6±4.3VS 4.7±2.1;t=33.71,P0.01)、PCT(0.38±0.13VS0.12±0.08;t=15.40,P0.01)比較,差異均具有統(tǒng)計學(xué)意義;ROC曲線分析顯示:以13.49ng/L為截點值,TNF-α診斷小兒上呼吸道感染的敏感性為90.00%,特異性為89.66%,曲線下面積為0.87,其結(jié)果優(yōu)于PCT、CRP。結(jié)論革蘭陰性菌是小兒上呼吸道感染的主要致病菌,并且測定CRP、PCT及TNF-α水平在小兒上呼吸道感染病情的診斷及評價方面具有一定的臨床意義。
[Abstract]:Objective to analyze the distribution of pathogenic bacteria and the change of serum inflammatory factors in children with upper respiratory tract infection. Methods from June 2015 to June 2016, 87 children with upper respiratory tract infection were selected as observation group and 80 healthy control group. The respiratory tract secretions of children in the observation group were collected with a sputum suction device to identify the pathogenic bacteria, and the levels of serum inflammatory factors in the two groups were compared at the same time. The ROC curve was used to analyze the diagnostic value of the related indexes in children with upper respiratory tract infection. Results 109 strains of pathogenic bacteria were isolated from children in the observation group. Among them 71 Gram-negative bacteria accounted for 65.14 and 38 Gram-positive bacteria accounted for 34.86.The top 5 pathogens were Haemophilus influenzae Streptococcus pneumoniae Escherichia coli Staphylococcus aureus Klebsiella pneumoniae. Compared with the control group, the serum inflammatory factor CRP(16.8 鹵6.7VS5.6 鹵3.2tU 13.59 TNF- 偽 was 22.6 鹵4.3VS 4.7 鹵2.1tU (33.71 鹵0.01), and compared with that in the control group (0.38 鹵0.13VS0.12 鹵0.08), and compared with that in the control group (0.38 鹵0.08 鹵0.08), and compared with that in the control group (P < 0.05), and compared with that in the control group (P < 0.05), and compared with that in the control group. The results showed that the sensitivity, specificity and area under the curve of 13.49ng/L for diagnosis of upper respiratory tract infection in children were 90.00,89.66 and 0.87, respectively. Conclusion Gram-negative bacteria is superior to 13.49ng/L in the diagnosis of infantile upper respiratory tract infection. The main pathogens of respiratory tract infections, The determination of CRPnPCT and TNF- 偽 levels is of clinical significance in the diagnosis and evaluation of upper respiratory tract infection in children.
【作者單位】： 咸寧市中心醫(yī)院湖北科技學(xué)院附屬第一醫(yī)院檢驗科;咸寧市婦幼保健院B超室;咸寧市中心醫(yī)院湖北科技學(xué)院附屬第一醫(yī)院肝膽外科;咸寧市中心醫(yī)院湖北科技學(xué)院附屬第一醫(yī)院藥劑科;嘉興市南湖區(qū)中心醫(yī)院內(nèi)科;
【基金】：湖北省科學(xué)技術(shù)廳基金資助項目(2015CFB685)
【分類號】：R446.5;R725.6

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