摘要
目的 :探讨快速细菌学诊断 (聚合酶链反应 ,PCR)与普通血培养的差异性及对 ICU全身性炎症反应综合征 (SIRS)患者治疗的指导意义。方法 :抽取 37例 40例次 SIRS患者的外周血标本 ,同时做普通血培养和PCR检测血中细菌 ,并根据 PCR检测结果指导临床使用抗生素 ,观察 1周的疗效。结果 :两种检测方法有明显的差异性 (χ2 =5 .142 ,P<0 .0 2 5 ) ,PCR法较灵敏。根据 PCR结果将病例分为 2组 ,阳性组 11例更换了抗生素或使用了高效、广谱抗生素 ,1周后 90 .91%的病例 SIRS状态得到有效控制 ;阴性组 2 6例未更换抗生素或加用抗生素 ,2例 1周内因原发病恶化死亡 (7.6 9% ) ,余 2 4例中 1周后 19例 SIRS状态没有恶化 (73.0 8% ) ,5例SIRS符合标准率上升 (19.2 3% )。结论 :PCR检测法较普通血培养法灵敏 ,对
Objective:To investigate the different between the rapidly diagnosis for bacteria (polymerase chain reaction, PCR) and blood culture and the effect for treatment with systemic inflammatory response syndrome (SIRS) in ICU.Methods:The blood samples of 40 cases with SIRS were drawn out for blood culture and PCR.The antibacteria agents were used according to the results of PCR.The effect of treatment were evaluated until one week.Results:There are significant difference between two methods(χ 2=5 142, P <0 025).The method of PCR was more sensitive than the other.The patients were divided into two groups according to the result of PCR.The positive group(11 cases) was changed or treated with power effect of antibacterial and the states of SIRS were well controlled after one week in 90 91% cases.Otherwise the negative group(26 cases) were not changed the application of antibacterial.Two cases(7 69%) died of the primary disease aggravated in one week,73 08% have not changed in states of SIRS,and 19 23% flared up in SIRS.Conclusions:The method of PCR is more sensitive in detecting bacteria and may direct the classic of pathogens and the treatment in patients with SIRS.
出处
《中国危重病急救医学》
CAS
CSCD
2001年第9期550-552,共3页
Chinese Critical Care Medicine
关键词
细菌
聚合酶链反应
全身性炎症反应综合征
诊断
bacteria
polymerase chain reaction
systemic inflammatory response syndrome
