血浆脂多糖浓度检测对器官移植患者革兰阴性细菌感染的诊断价值

The diagnosis significance of plasma lipopolysaccharide determination for Gram-negative bacterium infection in organ transplantation recipients

目的探讨血浆脂多糖（LPS）浓度检测对器官移植患者革兰阴性细菌（GNB）感染的诊断价值。方法回顾性分析160例疑似感染的器官移植患者的病史，根据细菌分离培养的结果将患者分为GNB感染组和对照组。采用动态比浊法检测患者就诊时外周血LPS浓度。以受试者工作特征（ROC）曲线评价LPS浓度检测对GNB感染的诊断价值。结果GNB感染组和对照组LPS浓度的中位数（四分位数）分别为33．58（22．12，73．59）和5．00（5．00，9．78）pg／mL，两者差异有统计学意义（P〈0．05）。LPS浓度检测诊断GNB感染的ROC曲线下面积为0．834（95％可信区间0．764-0．903）。当诊断界值设定为20pg／mL时，LPS浓度检测诊断GNB感染的敏感性为81．01％，特异性为88．89％。结论在器官移植患者中，LPS是诊断GNB感染的有效生物标志物。

Objective To evaluate the diagnosis significance of plasma lipopolysaccharide （LPS） determination for Gram-negative bacterium （GNB） infection in organ transplantation recipients. Methods The clinical data of 160 liver transplantation and kidney transplantation patients were analyzed retrospectively. According to the results of bacterium isolation culturing, there were 2 groups, GNB group and control group. The LPS concentrations were determined by dynamic turbidimetric assay. Receiver operating characteristic （ROC） curve was used to analyze the diagnosis significance of LPS for GNB infection. Results LPS in GNB group was 33.58 （22.12, 73.59） pg/mL, while it in control group was 5.00 （5.00,9.78） pg/mL. The difference was statistically significant （ P 〈 0.05 ）. The area under ROC curve was 0. 834 （95% confidence interval 0. 76443. 903 ）. The LPS determination sensitivity and specificity were 81.01% and 88.89%, respectively, at the cut-off value of 20 pg/mL. Conclusions LPS is an effective diagnosis biomarker for GNB infection in organ transplantation recipients.