炎症指标对血流感染患者病原菌的鉴别诊断评价

Effect of inflammatory indicators in differential diagnosis of patients with bloodstream infections

目的探究炎症指标对血流感染患者致病菌型别的鉴别诊断效果。方法选取2014年3月-2016年3月于医院进行住院治疗并进行血培养表现为阳性诊断的血流感染患者80例,按血培养菌种分为革兰阳性菌组35例和革兰阴性菌组42例,分析两组血流感染患者不同时期的白细胞(WBC)、血小板(PLT)、C-反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)等指标,记录两组血流感染患者的心率以及体温,比较两组患者各项指标之间的差异。结果两组患者年龄、体质量、性别差异均无统计学意义;革兰阴性菌与革兰阳性菌血流感染患者平均心率与体温比较无统计学差异;革兰阴性菌与革兰阳性菌导致的血流感染患者中,在发病早期其观察指标均有不同程度的改变,其中PLT及CRP的两组数据比较差异有统计学意义(P<0.05),WBC、PCT等观察指标差异无统计学意义,革兰阴性菌组患者WBC为(9.42±5.93)×109/L、PLT为(96.32±45.62)×109/L、CRP为(69.48±38.71ng/mL)、PCT为(4.12±7.81ng/mL)、IL-6为(543.20±1089.42pg/mL),革兰阳性菌组WBC为(9.11±4.52)×109/L、PLT为(203.76±49.51)×109/L、CRP为(42.84±36.37)ng/ml、PCT为(5.48±12.93)ng/ml、IL-6为(483.17±906.33)pg/ml。结论在两组导致的血流感染中,炎症指标可在病症早期作为快速诊疗手段,为早期的抗感染及治疗提供指导,为抗感染方案提供有效的依据,提高血流感染患者的治疗效率。

OBJECTIVE To explore the effect of inflammatory indicators on the differential diagnosis of pathogens in patients with bloodstream infections.METHODS A total of 80 cases with positive diagnosis of blood cultures of bloodstream infections in our hospital for hospitalization from Mar.2014 to Mar.2016 were selected, and were divided into gram-positive bacteria group with 35 cases and gram-negative bacteria group with 42 cases according to the difference of blood culture strains.The white blood cell （WBC）, platelet （PLT）, C-reactive protein（CRP）, procalcitonin （PCT） and interleukin-6 （IL-6） of patients with bloodstream infections in different periods were statistically analyzed.The heart rate and body temperature of patients with bloodstream infection were recorded.The differences between the two groups were compared.RESULTS There was no significant difference in age, body weight and genders between the two groups, and there was no significant difference in the mean heart rate and body temperature between the gram-negative bacteria and gram-positive bacteria patients with bloodstream infections.There were different degrees of changes of observation indicators in the early stages of disease in gram-negative bacteria and gram-positive bacteria patients with bloodstream infections, PLT and CRP of the two groups were significant （P＆lt;0.05） , WBC, PCT and other indicators had no significant difference.The WBC, PLT, CRP, PCT and IL-6 of gram-negative bacteria patients were （9.42±5.93）×10^9/L, （96.32±45.62）×10^9/L, （69.48±38.71）ng/mL, （4.12±7.81） ng/mL and （543.20±1089.42） pg/mL, and of gram-positive bacteria patients were （9.11±4.52）×10^9/L, （203.76±49.51）×10^9/L, （42.84±36.37） ng/ml, （5.48±12.93 ng/ml） and （483.17±906.33） pg/ml.CONCLUSION Among the patients with bloodstream infections, inflammatory indica-tors can be used as a means of rapid diagnosis and treatment at the early stage of disease, providing guidance for early anti-infection and treatment, providing effective basis for anti-infection scheme, and improving the efficiency of bloodstream infections.