重症急性胰腺炎合并细菌感染的快速诊断——附17例检测分析

Rapid diagnosis of severe acute pancreatitis complicated with bacterial infection

目的:探讨以16SrRNA基因为基础的细菌PCR法诊断重症急性胰腺炎早期合并细菌感染的价值。方法:17例疑有细菌感染的重症急性胰腺炎病人,术前B超引导下行胰周渗液细针穿刺检查,分别行以16SrRNA基因为基础的细菌PCR法检测和细菌培养。比较细菌PCR法检测结果和细菌培养结果。结果:17例中,PCR检测9例阳性,细菌培养10例阳性,该10例病人行手术治疗,术中所取胰周渗液行细菌培养证实为阳性。PCR检测重症急性胰腺炎合并细菌感染的敏感度为90%,特异度为100%。PCR法和细菌培养法分别需时5h和3d。结论:以16SrRNA基因为基础的细菌PCR法能快速、准确地诊断重症急性胰腺炎早期合并细菌感染,为手术治疗提供可靠依据。

Objective： To explore the value of 16S rRNA gene based bacteria polymerase chain reaction （PCR） method in early diagnosis of severe acute pancreatitis with bacterial infection. Methods： The peripancreatic fluid of 17 patients with severe acute pancreatitis were obtained by uhrasound-guided percutaneous fine needle aspiration. The 16S rRNA gene based bacteria PCR assay and bacteria conventional culture were used to detect bacteria infection. The consequences of PCR assay and bacteria conventional culture were compared. Results： Among 17 cases, 9 were diagnosed as pancreatic infection by PCR, 10 were diagnosed as pancreatic infection by conventional culture and treated with operation. The results by conventional culture of 10 operative patients were confirmed by operation. The sensitivity of PCR to diagnose pancreatic infection was 90% , the specificity was 100%. The time of PCR for obtaining the results was 5 hours, but conventional culture needs 3 days. Conclusion： The PCR is a rapid and accurate method to diagnoses infection in severe acute pancreatitis patients and can offer reliable evidence for operation.