本文選題：中性粒細(xì)胞堿性磷酸酶 + 骨科�。� 參考：《中華醫(yī)院感染學(xué)雜志》2017年14期

【摘要】：目的探討中性粒細(xì)胞堿性磷酸酶(NAP)在骨科患者感染中的診斷價(jià)值。方法選取2011年1月-2016年3月醫(yī)院骨科進(jìn)行I類手術(shù)的患者6253例,發(fā)生感染患者為感染組,在未發(fā)生感染的患者中隨機(jī)選取300例作為非感染組,術(shù)后1d,抽取外周靜脈血,檢測(cè)降鈣素原(PCT),C-反應(yīng)蛋白(CRP)和NAP,對(duì)感染患者進(jìn)行病原菌檢測(cè)。結(jié)果 6253例患者中共282例發(fā)生醫(yī)院感染,醫(yī)院感染率為4.5%;感染組NAP陽(yáng)性率、NAP積分、CRP和PCT均顯著高于非感染組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);282例感染患者共檢出病原菌282株,其中革蘭陽(yáng)性菌126株,占44.68%,革蘭陰性菌120株,占42.55%,支原體14株,占4.96%,病毒12株,占4.26%,其他菌株10株,占3.55%;革蘭陰性菌感染患者NAP陽(yáng)性率(99.53±0.15)和積分(452.36±65.28)均顯著高于革蘭陽(yáng)性菌感染患者的(86.33±5.17)和(292.15±46.37),兩組數(shù)據(jù)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),而革蘭陰性菌和革蘭陽(yáng)性菌感染患者CRP和PCT相比,差異無(wú)統(tǒng)計(jì)學(xué)意義;革蘭陽(yáng)性菌感染患者CRP(246.18±50.52)mg/L和PCT(1.25±0.26)ug/L顯著高于支原體感染患者的(135.35±35.15)mg/L和PCT(1.01±0.33)ug/L,兩組數(shù)據(jù)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),而革蘭陽(yáng)性菌和支原體感染患者NAP陽(yáng)性率和積分相比,差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 NAP活性檢測(cè)在骨科患者感染診斷方面具有重要臨床價(jià)值,對(duì)于快速診斷和療效判斷具有重要意義。
[Abstract]:Objective to investigate the diagnostic value of neutrophil alkaline phosphatase (NAPs) in orthopedic patients. Methods from January 2011 to March 2016, 6253 patients undergoing Class I surgery in orthopedic department of hospital were selected as infection group, and 300 patients without infection were randomly selected as non-infection group. Peripheral venous blood was extracted 1 day after operation. C- reactive protein (CRP) and NAPs of procalcitonin (PCT) were detected to detect pathogenic bacteria in infected patients. Results the nosocomial infection occurred in 6253 patients, the nosocomial infection rate was 4.5.The positive rate of NAP in the infected group was significantly higher than that in the non-infection group, and the difference was statistically significant (P 0.05). Of these, 126 were Gram-positive bacteria (44.68), 120 Gram-negative bacteria (42.55), 14 mycoplasma (4.96), 12 viruses (4.26), and 10 other strains. The positive rate of NAP in the patients with Gram-negative bacteria infection was 99.53 鹵0.15) and the score was 452.36 鹵65.28), which was significantly higher than that in the patients with Gram-positive bacteria infection (86.33 鹵5.17) and the patients with Gram-positive bacteria infection (292.15 鹵46.37g). The difference between the two groups was statistically significant (P 0.05), while the CRP and PCT of the patients with Gram-negative bacteria and Gram-positive bacteria infection were significantly higher than those of the patients with Gram-positive bacteria infection. CRP(246.18 鹵50.52)mg/L and PCT(1.25 鹵0.26)ug/L in patients with Gram-positive bacilli infection were significantly higher than those in patients with mycoplasma infection (135.35 鹵35.15)mg/L and PCT(1.01 鹵0.33ug-L). The difference between the two groups was statistically significant (P 0.05), but the positive rate and score of NAP in patients with Gram-positive bacteria and mycoplasma infection were higher than those in patients with mycoplasma infection. The difference was not statistically significant. Conclusion the detection of NAP activity has important clinical value in the diagnosis of infection in orthopedic patients, and is of great significance for rapid diagnosis and evaluation of curative effect.
【作者單位】： 浙江省嘉興市第二醫(yī)院骨科;浙江省嘉興市第二醫(yī)院麻醉科;
【基金】：浙江省嘉興市科技局基金資助項(xiàng)目(2014AY21031)
【分類號(hào)】：R687.3

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