用葡聚糖离心膜滤法快速诊断败血症

Rapid diagnosis of septicemia with dextran centrifugation and filtration

目的 快速分离血液中的细菌。方法 葡聚糖凝聚红细胞后 ,等密度离心 ,上清液用0 .2 2μm微孔滤膜过滤截留细菌、培养。结果 110例血标本采用离心膜滤法和常规血培养法细菌检出率无显著性差异 (χ2 =0 .2 5 ,P >0 .0 5 ) ;该两法检验结果有相关关系 (χ2 =6 1.6 4,P <0 .0 5 ) ,r =0 .82 88;离心膜滤法的细菌检出时间平均为 (2 4.5 5± 9.0 8) h,明显快于常规血培养法 (75 .2 7±12 .11) h(t=16 .5 4,P <0 .0 0 1)。其阳性似然比为 75 .43,阴性似然比为 0 .2 2。结论 离心膜滤法能快速诊断败血症 ,有较高的灵敏度和特异性。

Objective To rapidly isolate bacteria from blood. Methods Blood samples were coagulated with dextran and were centrifuged according to equal density. The supernatant was filtered through 0.22 μm millipore membrane. The filters were then placed on blood agar plates and cultured. Results There was no significant statistical difference between positive rate of dextran centrifugation and filtration and conventional blood culture method in 110 blood samples(χ 2=0 25,P>0.05). r=0.8288. The time of isolating bacteria in blood with dextran centrifugation and filtration was (24.55±9.08) h, shorter than that isolated with conventional blood culture method (75.27 h±12.11 h) (t=16.54,P<0.001). The positive likelihood ratio and the negative were 75.43 and 0.22 respectively. Conclusions Septicemia can be quickly diagnosed with dextran centrifugation and filtration. The method has high sensitivity and specificity.