發(fā)布時(shí)間：2018-12-25 10:37

【摘要】：目的探討重癥監(jiān)護(hù)病房中多藥耐藥鮑氏不動(dòng)桿菌(MDRAB)醫(yī)院獲得性肺炎(HAP)患者的免疫功能,各免疫指標(biāo)對(duì)醫(yī)院感染的預(yù)測(cè)價(jià)值及對(duì)預(yù)后的影響,以更好地指導(dǎo)臨床工作,降低患者病死率。方法采用病例對(duì)照研究方法,回顧性分析2011年6月-2016年6月廣西醫(yī)科大學(xué)第一附屬醫(yī)院MDRAB HAP 87例為病例組,并選取同時(shí)期非MDRAB HAP 62例為對(duì)照組,比較兩組患者T淋巴細(xì)胞、B淋巴細(xì)胞、免疫球蛋白、NK細(xì)胞計(jì)數(shù)等免疫指標(biāo)及降鈣素原、C-反應(yīng)蛋白、白細(xì)胞等炎性指標(biāo),觀察各免疫指標(biāo)及炎性指標(biāo)對(duì)醫(yī)院感染的預(yù)測(cè)作用,應(yīng)用單因素分析法進(jìn)行比較兩組中各免疫指標(biāo)及炎性指標(biāo)有無(wú)差異;應(yīng)用ROC曲線評(píng)估各指標(biāo)對(duì)醫(yī)院感染的預(yù)測(cè)價(jià)值。結(jié)果 APACHEⅡ評(píng)分差異有統(tǒng)計(jì)學(xué)意義(P0.05);對(duì)于免疫指標(biāo),兩組總T細(xì)胞、CD_8~+T淋巴細(xì)胞、免疫球蛋白M、免疫球蛋白G、NK細(xì)胞均無(wú)統(tǒng)計(jì)學(xué)意義,但兩組中CD_4~+T淋巴細(xì)胞差異有統(tǒng)計(jì)學(xué)意義(P0.05),免疫球蛋白A水平有顯著差異(P0.05),繪制CD_4~+T淋巴細(xì)胞和免疫球蛋白A預(yù)測(cè)HAP的ROC曲線均具有較大診斷價(jià)值;炎性指標(biāo)的研究中,患者白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞百分比、降鈣素原、C-反應(yīng)蛋白比較差異無(wú)統(tǒng)計(jì)學(xué)意義,但淋巴細(xì)胞差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論免疫指標(biāo)CD_4~+T細(xì)胞、免疫球蛋白A、APACHEⅡ評(píng)分對(duì)指導(dǎo)重癥監(jiān)護(hù)病房中HAP患者的臨床治療有重要價(jià)值,對(duì)MDRAB HAP患者的免疫功能及其預(yù)后的評(píng)估具有重要意義。
[Abstract]:Objective to investigate the immune function of (HAP) patients with multidrug resistant Acinetobacter baumannii (MDRAB) hospital acquired pneumonia in intensive care unit (ICU), the predictive value of each immune index to nosocomial infection and its influence on prognosis, so as to better guide the clinical work. Reduce the mortality of patients. Methods from June 2011 to June 2016, 87 cases of MDRAB HAP in the first affiliated Hospital of Guangxi Medical University were analyzed retrospectively, and 62 cases of non-MDRAB HAP in the same period were selected as the control group. The T lymphocytes were compared between the two groups. B lymphocyte, immunoglobulin, NK cell count, procalcitonin, C-reactive protein, leukocyte and other inflammatory indexes were observed to predict nosocomial infection. Single factor analysis was used to compare the difference of immune and inflammatory indexes between the two groups. ROC curve was used to evaluate the predictive value of each index for nosocomial infection. Results there was significant difference in APACHE 鈪，

本文編號(hào)：2391066