本文選題：醫(yī)院獲得性感染 + 社區(qū)獲得性肺炎　； 參考：《中國呼吸與危重監(jiān)護雜志》2016年01期

【摘要】：目的探討重癥監(jiān)護病房(ICU)內(nèi)醫(yī)院獲得性感染的影響因素以及CD3~+CD4~+T細胞對醫(yī)院感染的預(yù)測價值。方法選擇2014年3月至2014年12月在上海市閔行區(qū)中心醫(yī)院ICU及呼吸內(nèi)科住院的111例住院患者。其中社區(qū)獲得性肺炎患者33例為社區(qū)獲得性肺炎組(CAP組),入住ICU而未發(fā)生醫(yī)院獲得性感染的患者31例為無醫(yī)院獲得性感染組(NNI組),入住ICU并發(fā)生醫(yī)院獲得性肺炎的患者47例為醫(yī)院獲得性肺炎組(HAP組)。比較三組患者T淋巴細胞、B淋巴細胞及CD3~+CD4~+、CD3~+CD8~+、NK細胞計數(shù)等指標(biāo),觀察CD3~+CD4~+T細胞對醫(yī)院感染的預(yù)測作用。結(jié)果三組患者性別、年齡等指標(biāo)差異無統(tǒng)計學(xué)意義(P0.05),APACHEⅡ評分差異有統(tǒng)計學(xué)意義(P=0.025)。與其他兩組比較,HAP組患者CD3~+CD4~+T淋巴細胞計數(shù)減少(P=0.005)。繪制受試者工作特征(ROC)曲線,CD3~+CD4~+T淋巴細胞計數(shù)預(yù)測HAP的ROC曲線下面積(AUC)為0.660,閾值為29.96%,敏感性93.8%特異性40.4%。三組患者T淋巴細胞百分比(P=0.001)、B淋巴細胞計數(shù)(P=0.021)差異有統(tǒng)計學(xué)意義,CD3~+CD8~+淋巴細胞、NK細胞、CD3~+CD4~+/CD3~+CD8~+T淋巴細胞比較差異無統(tǒng)計學(xué)意義(P0.05)。三組患者C4水平有顯著差異(P=0.003),C3水平無顯著差異(P0.05),IgG、IgM、IgA、IgE無顯著差異(P0.05)。三組患者白細胞及中性粒細胞計數(shù)、降鈣素原、C反應(yīng)蛋白比較差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論 CD3~+CD4~+T細胞可以作為一個醫(yī)院感染的獨立預(yù)測因素,對臨床工作具有指導(dǎo)意義。
[Abstract]:Objective to investigate the influencing factors of nosocomial infection in intensive care unit (ICU) and the predictive value of CD3 ~ CD4 ~ T cells in nosocomial infection. Methods 111 inpatients from ICU and Department of Respiratory Medicine in Shanghai Minhang District Central Hospital from March 2014 to December 2014 were selected. Among them, 33 patients with community-acquired pneumonia (CAP group) and 31 patients without nosocomial infection (NNI group) were admitted to ICU with nosocomial pneumonia. Forty-seven patients were treated with nosocomial pneumonia (HAP). To compare the counts of T lymphocyte B lymphocytes and CD3 ~ CD4 ~ + CD3 ~ CD8 ~ + NK cells in three groups, and to observe the predictive effect of CD3 ~ CD4 ~ T cells on nosocomial infection. Results there was no significant difference in sex, age and other indexes among the three groups (P0.05). There was significant difference in Apache 鈪，

本文編號：2101078