摘要
目的探讨血液中炎性指标与脓毒血症细菌感染患者病情的相关性。方法选取2010年9月-2015年2月该院收治的脓毒血症细菌感染患者109例,依据病情程度分为脓毒性休克组、严重脓毒血症组、脓毒血症组。统计感染菌分布情况,比较各亚组脓毒血症患者的急性生理和慢性健康评分(APACHE-Ⅱ)、降钙素原(PCT)、C反应蛋白(CRP)、脂多糖(LPS)、白细胞介素-6(IL-6)、白细胞计数(WBC)、中性粒细胞比例(NEUT)等炎性指标水平,并对炎性指标与APACHE-Ⅱ评分进行相关性分析。结果脓毒血症患者主要感染菌为大肠埃希菌、肺炎克雷伯菌、血浆凝固酶阴性葡萄球菌、金黄色葡萄球菌、假丝酵母菌,感染率分别为22.94%、21.10%、13.76%、11.93%和9.17%,其次为鲍曼不动杆菌(7.34%)、阴沟肠杆菌(5.50%)。脓毒性休克组、严重脓毒血症组、脓毒血症组患者的APACHE-Ⅱ评分分别为(26.27±5.68)、(21.08±4.96)和(12.14±3.75)分。脓毒性休克组、严重脓毒血症组、脓毒血症组患者血液中PCT、CRP、LPS、IL-6、WBC、NEUT等炎性指标水平依次降低,差异有统计学意义(P<0.05)。脓毒血症细菌感染患者的血液中PCT、CRP、LPS、IL-6与APACHE-Ⅱ评分呈正相关(r=0.579、0.734、0.621和0.685,P<0.05)。结论脓毒血症患者细菌感染以大肠埃希菌、肺炎克雷伯菌、血浆凝固酶阴性葡萄球菌为主,患者血液中PCT、CRP、LPS、IL-6水平与病情呈正相关,可作为预测病情及预后的重要指标。
Objective To investigate the correlation between blood inflammatory markers and patients＇ condition in patients with sepsis-related bacterial infection. Methods A total of 109 patients, who were admitted to the hospital for sepsis bacterial infections from September 2010 to February 2015, were selected and divided to septic-shock group, severe-sepsis group and sepsis group according to the severity of disease. Distribution of infectious bacteria was investigated. Acute physiology and chronic health evaluation（APACHE- Ⅱ） score,procalcitonin（PCT）, C-reactive protein（CRP）, lipopolysacchride（LPS）, interleukin 6（IL-6）, white blood cell count（WBC）, neutrophil percentage（NEUT） and other inflammatory marker levels were compared among the groups; and the correlations between the inflammatory markers and APACHE-Ⅱ score were analyzed. Results The main bacteria of sepsis were Escherichia coli, Klebsiella pneumonia, coagulase-negative Staphylococci,Staphylococcus aureus and Candida yeast with infection rates were 22.94%, 21.10% and 13.76%, 11.93% and9.17% respectively, followed by Acinetobacter baumannii（7.34%） and Enterobacter cloacae（5.50%）. The APACHE- Ⅱ scores of the septic-shock group, the severe-sepsis group and the sepsis group were（26.27 ±5.68）,（21.08 ± 4.96） and（12.14 ± 3.75） respectively. The blood PCT, CRP, LPS, IL-6, WBC and NEUT decreased in turn in the septic-shock group, the severe-sepsis group and the sepsis group, and the differences were statistically significant（P〈0.05）. In the sepsis patients with bacterial infection, the APACHE-Ⅱ scores were positively correlated with the blood PCT, CRP, LPS and IL-6（r = 0.579, 0.734, 0.621 and 0.685; P〈0.05）. Conclusions The infectious bacteria in sepsis patients are mainly Escherichia coli, Klebsiella pneumonia,plasma coagulase-negative Staphylococcus. Blood PCT, CRP, LPS and IL-6 levels are positively correlated with the severity of the disease, which can be used as indicators for predicting the condition and prognosis.
出处
《中国现代医学杂志》
CAS
北大核心
2016年第9期97-100,共4页
China Journal of Modern Medicine
关键词
炎性指标
脓毒血症
细菌感染
inflammatory index
sepsis
bacterial infection
