摘要
目的比较革兰阴性菌与革兰阳性菌致脓毒症患者血常规指标及患者炎症因子水平,为脓毒症的早期诊断及治疗提供参考。方法本院收治的细菌性脓毒症患者200例,抽取静脉血做细菌培养检查,根据病原菌类型分为革兰阴性菌组(74例)和革兰阳性菌组(126例),观察两组患者病原菌分布情况;同时做血常规检查,比较两组患者血液白细胞(WBC)数量、中性粒细胞(NEU)数量、淋巴细胞(LYM数量)、降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平。结果革兰阴性菌组脓毒症患者感染病原菌以鲍曼不动杆菌和铜绿假单胞菌为主,分别占36.49%和18.92%;革兰阳性菌组感染病原菌以屎肠球菌和葡萄球菌属为主,分别占30.95%和43.65%。两组脓毒症患者外周血WBC、NEU及CRP水平差异无统计学意义(P>0.05)。革兰阴性菌组脓毒症患者外周血LYM、PCT及TNF-α分别为(1.06±0.27)×10^9/L、(9.62±0.86)ng/ml、(1.02±0.29)ng/ml,革兰阳性菌组分别为(0.71±0.15)×10^9/L、(7.51±0.70)ng/ml、(0.68±0.16)ng/ml,差异均有统计学意义(P<0.05)。结论革兰阴性菌与革兰阳性菌感染所致脓毒症临床表现不同。革兰阴性菌可导致机体产生更加严重的免疫紊乱及炎症反应。
Objective To compare routine blood indices and levels of inflammatory factors in patients with sepsis due to Gram-negative or Gram-positive bacteria.Methods Subjects were 200 patients with bacterial sepsis who were treated at this Hospital.Venous blood was taken for bacterial culture.Depending on the type of pathogen,patients were divided into those infected with Gram-negative bacteria (74 patients)and those infected with Gram-positive bacteria (126 patients).The prevalence of pathogens was determined in the 2 groups.Routine blood tests were performed,and the white blood cell count (WBC),the neutrophii count (NEU),the lymphocyte count (LYM),and levels of procalcitonin (PCT), C-reactive protein (CRP),and tumor necrosis factor-α(TNF-α) levels were compared.Results The Gram-negative bacteria causing sepsis were mainly Acinetobacter baumannii (36.49%) and Pseudomonas aeruginosa (18.92%).The Gram-positive bacteria causing sepsis were mainly Enterococcus faecium (30.95%) and Staphylococcus (43.65%). There were no significant differences in the WBC and NEU counts and the CRP level between the two groups of patients with sepsis (P>0.05).The LYM count and PCT and TNF-α levels in peripheral blood from patients with sepsis due to Gram-negative bacteria were 1.06±0.27×10^9/L,9.62±0.86ng/ml,and 1.02±0.29ng/ml,respectively.The LYM count and PCT and TNF-α levels in peripheral blood from patients with sepsis due to Gram-positive bacteria were 0.71±0.15×10^9/L,7.51×0.70ng/ml,0.68±0.16ng/ml.The LYM count and PCT and TNF-α levels differed significantly between the 2 groups of patients (P<0.05).Conclusion The clinical manifestations of infections with Gram-negative bacteria and Gram-positive bacteria differ.Gram-negative bacteria can cause more serious immune disorders and inflammatory reactions.
作者
张红伟
杜辉
于占彪
徐放
ZHANG Hong-wei;DU Hui;YU Zhan-biao;XU Fang(Intensive Care Unit,Hebei University Hospital,Baoding 071000,Hebei,China;Neurology,Baoding Cerebrovascular Disease Hospital)
出处
《中国病原生物学杂志》
CSCD
北大核心
2018年第11期1269-1271,共3页
Journal of Pathogen Biology
基金
保定市科技计划项目(No.18ZF050)
关键词
革兰阴性菌
革兰阳性菌
脓毒症
血常规检查
炎症因子
Gram-negative bacteria
Gram-positive bacteria
sepsis
routine blood tests
inflammatory factors
