系统性炎症指标在深部真菌感染患者中检测的应用价值

Application value of systemic inflammation in detection of deep fungal infection

目的探讨系统性炎症指标在深部真菌感染(DFI)患者诊疗中的应用价值。方法选取2012年11月-2014年3月本院266例高度疑似危重病并发单纯深部真菌感染患者为研究对象,回顾分析临床资料,按疗效分为好转组(182例)和恶化组(84例),动态监测DFI患者治疗前后血NLR、PLR、CRP和PCT系统性炎症指标,并评估上述指标在危重病并发单纯深部真菌感染患者的病情严重程度及预后价值。结果好转组治疗前NLR、PLR水平均高于恶化组,CRP、PCT水平均低于恶化组;好转组治疗后,各指标水平均显著降低,差异均有统计学意义(P<0.05);恶化组在治疗后,NLR、PLR水平无明显变化,随着合并细菌感染机率增加及病情恶化,CRP、PCT水平反而较治疗前升高。结论动态检测危重病并发单纯深部真菌感染患者治疗前后血中NLR、PLR、CRP和PCT水平可反映病情严重程度及预测疾病预后。

Objective To explore the value of systemic indicators of inflammation in diagnosis and treatment of deep fungal infection（ DFI）. Methods During November 2012-March 2014,266 cases of highly suspected critically ill patients with simple deep fungal infection in our hospital were selected in this study. The clinical data of these patients were retrospectively analyzed.According to the treatment effect,the patients were divided into the improved group（ 182 cases） and the deterioration group（ 84 cases）. The levels of systemic indicators of inflammation including NLR,PLR,CRP and PCT were measured before and after treatment in DFI patients. And to assess the value of these indicators in assessing the severity and prognosis of critically ill patients with simple deep fungal infections. Results Before treatment,the levels of NLR and PLR in the improved group were significantly higher than those in the deterioration group and CRP and PCT were significantly lower than those in the deterioration group,with the differences statistically significant（ P〈0. 05）. After treatment,the level of each index in the improved group significantly decreased. In the deterioration group,the levels of NLR and PLR after treatment had no significant changes,and with the increase of the probability of bacterial infection and the deterioration of the disease,the levels of CRP and PCT were higher than that before treatment. Conclusion The levels of NLR,PLR,CRP and PCT in critically ill patients with deep simple fungal infection before and after treatment can reflect the severity of the disease and predict the prognosis of the disease.