本文選題：溶菌酶 + 乳鐵蛋白�。� 參考：《南京大學》2015年碩士論文

【摘要】：目的：探討血清溶菌酶活性和乳鐵蛋白含量以及常規(guī)的紅細胞沉降率,CRP檢測對于骨感染患者與非感染骨折患者之間的鑒別診斷價值,以及它們對于骨感染患者是否處于處于細菌活動期的評估價值。方法：骨感染患者和非感染骨折患者共29名,其中19名患者為骨感染組,10名患者為非感染骨折組；按細菌培養(yǎng)結果將骨感染患者分為細菌培養(yǎng)陽性組和細菌培養(yǎng)陰性組,細菌培養(yǎng)陽性組11人,陰性組8人。所有患者人院后48小時內(nèi)抽靜脈血檢測血清溶菌酶活性和乳鐵蛋白含量,紅細胞沉降率、C反應蛋白。對比分析骨感染組和骨折組各項指標檢測結果；細菌培養(yǎng)陽性組和細菌培養(yǎng)陰性組各項指標檢測結果。結果：骨感染組的血清溶菌酶活性為1405.09±178.79iu/1,骨折組血清溶菌酶活性為1370.85±203.88iu/1,兩組間差異無統(tǒng)計學意義(p0.05)；骨感染組血清乳鐵蛋白含量為151.52±26.24 μg/ml,骨折組血清乳鐵蛋白含量為91.46±21.74 μg/ml,兩組間差異有統(tǒng)計學意義(p0.01)；骨感染組ESR為30.21±24.18mm/h,骨折組ESR為7.80±3.39mm/h；兩組間差異有統(tǒng)計學意義(p0.01)。骨感染組CRP為18.65±23.96mg/l,骨折組CRP為4.17±2.39mg/l；兩組間差異有統(tǒng)計學意義(p0.05)。骨感染組中的細菌培養(yǎng)陽性組血清溶菌酶活性為1368.92±180.62iu/l,細菌培養(yǎng)陰性組血清溶菌酶活性為1487.69±192.22iu/l,兩組間差異無統(tǒng)計學意義(p0.05)；細菌培養(yǎng)陽性組血清乳鐵蛋白含量為154.71±28.57mg/l,細菌培養(yǎng)陰性組血清乳鐵蛋白含量為147.30±27.60mg/l,兩組間差異無統(tǒng)計學意義(p0.05)。細菌培養(yǎng)陽性組ESR為40.36±27.44mm/h,細菌培養(yǎng)陰性組ESR為16.25±6.62mm/h,兩組間差異有統(tǒng)計學意義(p0.05)；細菌培養(yǎng)陽性組CRP為27.54±26.61mg/l,細菌培養(yǎng)陰性組為16.43±10.38mg/l。兩組間差異無統(tǒng)計學意義(p0.05)結論：傳統(tǒng)的ESR,CRP檢查盡管敏感性較差容易被其他疾病或組織損傷影響但仍是骨感染檢查不可或缺的部分,ESR可以有效反應患者的細菌活動性情況。單憑血清溶菌酶檢測無法鑒別骨感染和普通骨折患者；血清乳鐵蛋白含量的檢測對于骨感染患者診斷有一定參考價值和臨床意義。但是由于本研究病例數(shù)量較少,因此對于乳鐵蛋白對于骨感染患者確診及感染狀態(tài)的評估有待進一步臨床研究。
[Abstract]:Objective: to investigate the value of serum lysozyme activity, lactoferrin content and erythrocyte sedimentation rate (RBC) and CRP in differential diagnosis between bone infection patients and non-infected fracture patients. And their value in evaluating whether patients with bone infection are in bacterial activity. Methods: there were 29 patients with bone infection and non-infection fracture, 19 of them were bone infection group, 10 patients were non-infection fracture group, according to the result of bacterial culture, bone infection patients were divided into two groups: positive group and negative group. Bacteria culture positive group 11 people, negative group 8 people. The serum lysozyme activity, lactoferrin content, erythrocyte sedimentation rate and C-reactive protein were measured within 48 hours after hospitalization. The indexes of bone infection group and fracture group were compared and analyzed, and the results of bacterial culture positive group and bacterial culture negative group were analyzed. Results: the serum lysozyme activity of bone infection group was 1405.09 鹵178.79 IU / 1, and the serum lysozyme activity of fracture group was 1370.85 鹵203.88 IU / 1. There was no significant difference between the two groups (p 0.05). The serum lactoferrin content of bone infection group was 151.52 鹵26.24 渭 g / ml, the serum lactoferrin content of fracture group was 91.46 鹵21.74 渭 g / ml, the difference between the two groups was statistically significant (p 0.01), the ESR of bone infection group was 30.21 鹵24.18 mm / h, and that of fracture group was 7.80 鹵3.39 mm / h, the difference between the two groups was significant (p 0.01). CRP in bone infection group was 18.65 鹵23.96 mg / L, and that in fracture group was 4.17 鹵2.39 mg / L, there was significant difference between the two groups (P 0.05). The serum lysozyme activity in the positive group was 1368.92 鹵180.62iu / l, and that in the negative group was 1487.69 鹵192.22iu / l, there was no significant difference between the two groups (p 0.05). The serum lactoferrin content in positive group was 154.71 鹵28.57 mg / l, and that in negative group was 147.30 鹵27.60 mg / l. There was no significant difference between the two groups. The ESR of positive group was 40.36 鹵27.44 mm / h, and that of negative group was 16.25 鹵6.62 mm / h (P < 0.05), the CRP of positive group was 27.54 鹵26.61 mg / L, and that of negative group was 16.43 鹵10.38 mg / L. Conclusion: although the sensitivity of traditional ESR-CRP is not easily affected by other diseases or tissue injury, ESR is still an indispensable part of bone infection examination, which can effectively reflect the bacterial activity of patients. Serum lysozyme detection alone can not distinguish bone infection from common fracture patients, and the detection of serum lactoferrin content has certain reference value and clinical significance for the diagnosis of bone infection patients. However, due to the small number of cases in this study, the evaluation of lactoferrin for the diagnosis and infection status of patients with bone infection needs further clinical research.
【學位授予單位】：南京大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R681.2;R446.1

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相關期刊論文 前1條

1 劉立峰;鄒林;蔡錦方;;創(chuàng)傷性骨髓炎[J];中國矯形外科雜志;2009年10期

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本文編號：2048628