本文選題：重癥多發(fā)傷　切入點：多部位感染　出處：《中華醫(yī)院感染學(xué)雜志》2016年11期 　論文類型：期刊論文

【摘要】：目的探討連續(xù)監(jiān)測單核細胞表面人類白細胞抗原DR(human leukocyte antigen-DR,HLA-DR)表達率變化在重癥多發(fā)傷患者預(yù)后判斷中的臨床意義,為重癥多發(fā)傷患者的感染預(yù)防治療尋找參考指標。方法選擇2013年2月-2015年2月醫(yī)院ICU收治的54例重癥多發(fā)傷患者為研究對象,用流式細胞術(shù)檢測其入院時以及第2、4、6、8、10、15天外周血CD14陽性單核細胞表面HLA-DR表達率;根據(jù)患者28d內(nèi)感染情況分為多部位感染組15例、非多部位感染組39例,分析HLA-DR表達率變化規(guī)律與多部位感染的關(guān)系。結(jié)果 54例重癥多發(fā)傷患者中有15例發(fā)生多部位感染,感染率達27.8%;ROC曲線分析顯示,第4、6、8天的HLA-DR表達率及其與入院時的HLA-DR表達率的差值預(yù)測重癥多發(fā)傷患者多部位感染,差異有統(tǒng)計學(xué)意義(P0.01),曲線下面積分別為0.804、0.913、0.953、0.768、0.875、0.934;HLA-DR8≤58%預(yù)測多部位感染的敏感性為93.3%、特異性為89.7%;HLA-DR6≤49%預(yù)測多部位感染的敏感性為80.0%、特異性為89.7%;△HLA-DR6-0≤-27%預(yù)測多部位感染的敏感性為80.0%,特異性為82.0%;△HLA-DR8-0≤-7%預(yù)測多部位感染的敏感性為97.4%、特異性為76.9%;各參數(shù)的陽性預(yù)測值低,陰性預(yù)測值高。結(jié)論外周血單核細胞表面HLA-DR表達率的連續(xù)監(jiān)測在預(yù)測重癥多發(fā)傷患者多部位感染,判斷預(yù)后和預(yù)防治療感染中具重要價值。
[Abstract]:Objective to investigate the clinical significance of continuously monitoring the expression of human leukocyte antigen (DR(human leukocyte antigen-DRN) on the surface of monocytes in the prognosis of patients with severe multiple injury. Methods 54 patients with severe multiple injuries treated in ICU from February 2013 to February 2015 were selected as the study objects. The expression rate of HLA-DR on the surface of CD14 positive monocytes in peripheral blood was detected by flow cytometry on admission to hospital and on day 1 015 of the 2nd day, and was divided into multi-site infection group (n = 15) and non-multisite infection group (n = 39) according to the infection condition within 28 days. Results among 54 patients with severe multiple injuries, 15 cases had multiple site infection, and the infection rate was 27.810%. The expression rate of HLA-DR and the difference between the expression rate of HLA-DR and the rate of HLA-DR expression on admission were used to predict multisite infection in patients with severe multiple trauma. The difference was statistically significant (P 0.01), and the area under the curve was 0.804 / 0.9130.9530.680.87534A, respectively. The sensitivity of HLA-DR8 鈮，

本文編號：1647632