髓过氧化物酶指数与革兰阴性菌脓毒症的关系

Relation between myeloperoxidase index and Gram-negative bacterial sepsis

目的监测脓毒症患者炎症参数的变化,尤其是髓过氧化物指数(MPXI)的改变对脓毒症的诊断及其细菌类型的区分。方法 183例细菌感染患者分为局部感染组、系统性炎性反应综合征组(SIRS)、脓毒症组,54例健康体检者为对照组。测定患者入院时、第1、5、10天炎症情况并作比较分析。结果入院时患者炎症状态明显不同,局部感染和脓毒症患者,MPXI均降低;其他患者炎症指标均升高,差异具有统计学意义(P<0.05);脓毒症患者及SIRS患者MPXI从第1天开始就发生变化,炎症患者降钙素原(PCT)从第5天开始升高;入院时MPXI预示革兰阴性脓毒症感染特异度为62.1%,灵敏度为70.3%,-2.1为最佳临界点。结论脓毒症患者MPXI水平降低,其改变可作为脓毒症诊断及感染细菌类型的区分。

Objective To monitor the changes of inflammatory parameters in sepsis patients ,especially the change of myeloper‐oxidase index （M PXI ） for differentiating the sepsis diagnosis and bacterial types .Methods One‐hundred and eighty‐three patients with bacterial infections were divided into the local infection group ,systemic inflammatory response syndrome （SIRS） group and sepsis group .Fifty‐four individuals undergoing healthy physical examination served as the control group .The inflammation situation at admission ,on 1 ,5 ,10 d after admission was detected for conducting the comparative analysis .Results The inflammatory status at admission was obviously different from various groups ,MPXI in the patients with local infection and sepsis was decreased;the in‐flammatory indicators in other patients were increased ,the differences were statistically significant（P〈 0 .05）;MPXI began to change on 1 d in the patients with sepsis and SIRS ,procalcitonin（PCT ） in the inflammatory patients began to increase on 5 d;the specificity and sensitivity of MPXI predicting Gram‐negative bacterial sepsis infection at admission were 62 .1% and 70 .3% respec‐tively ,the optimal critical point was -2 .1 .Conclusion MPXI is decreased in sepsis patients ,which can serve as differentiation of sepsis diagnosis and infected bacterial type .