不同病原菌血流感染血清炎症因子的测定及对病情程度、预后的判断价值研究

摘要

Objective:To investigate the serum inflammatory cytokines expression in different pathogens and to explore the value of serum inflammatory cytokines in judging the severity of disease and assessing prognosis.Methods:We retrospec-tively analyzed 90 cases of bloodstream infections admitted to our hospital from October 2016 to November 2017 and regarded it as observation group,while the control group was 80 patients with negative blood cultures over the same period.Serum in-flammatory factors PCT,C-reactive protein(CRP),white blood cell count(WBC),neutrophil percentage(NEUT)and Endo-toxin levels were compared between the two groups.The levels of serum inflammatory factors PCT,CRP,WBC,NEUT and Endotoxin in patients with Gram-positive(G+),Gram-negative(G-),treatment improvement and treatment ineffective group were compared.Result:The levels of PCT,CRP,WBC,NEUT and Endotoxin in patients with positive blood flow culture were significantly higher than those with negative blood culture(P<0.05).Compared with the G+ group,the levels of PCT, CRP,WBC and Endotoxin in the G-group were significantly higher(P<0.05).There was no significant difference in the level of NEUT in two groups(P>0.05).Compared with the treatment-ineffective group,the therapeutic improvement group PCT, CRP,WBC,NEUT and Endotoxin levels decreased significantly.The levels of PCT,CRP,WBC,NEUT and endotoxin in pa-tients with moderate and severe bloodstream infections were significantly higher than those with mild infections;the levels of PCT,CRP,WBC,NEUT and endotoxin in patients with moderate infection were significantly higher than those with mild in-fections,and all has statistical significance(P<0.05).Conclusion:PCT,CRP,WBC,NEUT and Endotoxin can be used as auxiliary diagnostic indicators of bloodstream infections,which can be used to judge the severity of bloodstream infection and e-valuate the prognosis.%目的:通过检测不同病原菌血流感染血清炎症因子的表达水平,探讨血清炎症因子对判断病情程度及评估预后的价值.方法:采用回顾性分析我院收治的90例血培养阳性患者并作为观察组,对照组为80例同期血培养阴性患者.比较两组血清炎症因子 PCT、C 反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞百分比(NEU T)和内毒素(Endotoxin)水平.检测观察组中革兰性阳性(G+)、革兰氏阴性(G-)组及治疗好转组、治疗无效组患者血清炎症因子PCT、CRP、WBC、NEU T 和内毒素水平并比较.结果:血流培养阳性的观察组PCT、CRP、WBC、NEU T 和内毒素水平均明显高于血流培养阴性的对照组(P<0.05).与G+组比较,G-组患者PCT、CRP、WBC和内毒素水平明显升高(P<0.05),两组NEU T水平比较无统计学意义(P>0.05).与治疗无效组相比,治疗好转组PCT、CRP、WBC、NEU T和内毒素水平明显低于对照组.中度、重度血流感染患者PCT、CRP、WBC、NEU T 和内毒素表达水平显著高于轻度感染患者;与轻度感染患者比较,中度感染患者PCT、CRP、WBC、NEU T 和内毒素水平升高,均具有统计学意义(P<0.05).结论:PCT、CRP、WBC、NEU T 和内毒素可作为血流感染疾病的辅助诊断指标,可用于判断血流感染疾病的病情程度及评估预后.