摘要
目的探讨早期联合各类炎症指标对于鉴别不同病原菌血流感染的价值。方法收集2011年1月-2015年12月本院血培养阳性患者152例为血培养阳性组,根据血培养结果分为革兰阴性菌组、革兰阳性菌组及真菌组,同时收集50例血培养结果阴性者作为对照组,记录入院后第1 d的炎症相关实验室指标结果,用Logistic回归分析探讨不同病原菌血流感染的鉴别指标。结果血培养阳性组共152例,其中革兰阴性菌占50.0%（76/152）,革兰阳性菌占46.1%（70/152）,真菌占3.9%（6/152）;3组间CRP、PCT、NLR、PLR、RDW、ESR及PA/Fig的差异有统计学意义（P均〈0.05）。革兰阴性菌组NLR与PA/Fig差异有统计学意义（P〈0.05）[OR及95%CI分别为：1.119（1.019～1.229）;0.563（0.360～0.880）];革兰阳性菌组PLR及ESR差异有统计学意义（P〈0.05）[OR及95%CI分别为：1.078（1.053～1.128）、1.022（1.001～1.043）];真菌组RDW值差异有统计学意义（P〈0.05）[OR及95%CI：1.292（1.039～1.607）]。结论 NLR及PA/Fig可鉴别革兰阴性菌血流感染,PLR及ESR可鉴别革兰阳性菌血流感染,RDW值可鉴别真菌血流感染。
Objective To explore the early diagnostic value of combined detection of various kinds of inflammation indexes in identifying the bloodstream infection of different organisms. Methods 152 cases with positive blood culture from January 2011 to December 2015 were collected from our hospital. All cases were divided into gram negative bacteria group,gram positive bacteria group and fungi group according to the results of blood culture. And 50 cases with negative blood culture were collected as the control group. Results of inflammation related laboratory indexes of all cases at 1 d were collected to explore the indexes to identify different organisms by using Logistic regression. Results There were 152 cases with positive blood culture,including50. 0%（ 76 /152） of gram negative bacteria,46. 1%（ 70 /152） of gram positive bacteria,3. 9%（ 6 /152） of fungi group. Differences of PCT,NLR,PLR,,RDW,ESR,PA / Fig and CRP among the three groups were statistically significant（ P〈0. 05）.Logistic regression analysis showed that in gram negative bacteria group,the differences of NLR and PA / Fig were statistically significant[OR and its 95% CI were 1. 119（ 1. 019- 1. 229）,0. 563（ 0. 360- 0. 880）,respectively]. In gram positive bacteria group,the differences of PLR and ESR were statistically significant[OR and its 95% CI were 1. 078（ 1. 053- 1. 128）,1. 022（ 1. 001- 1. 043）,respectively]. RDW difference was statistically significant in fungi group[OR and its 95% CI： 1. 292（ 1. 039- 1. 607） ]. Conclusion NLR and PA/Fig can be used to identify gram negative bacterial bloodstream infection. PLR and ESR can identify the bloodstream infections of gram positive bacteria,and RDW can be used to identify the fungal bloodstream infections.
作者
颜文洁
YAN Wen-jie(Clinical Laboratory, Wenling Traditional Chinese Medicine Hospital, Wenling, Zhejiang 317500, China)
出处
《中国卫生检验杂志》
CAS
2016年第22期3263-3266,共4页
Chinese Journal of Health Laboratory Technology
关键词
血流感染
革兰阴性菌
革兰阳性菌
真菌
炎症
实验室指标
Bloodstream infection
Gram negative bacteria
Gram positive bacteria
Fungi
Inflammation
Laboratory indexes
