住院患者血清降钙素原与病原微生物的关系分析

Analysis of the relationship between serum procalcitonin and pathogenic microorganisms in hospitalized patients

目的探讨血清降钙素原与病原微生物之间的关系。方法回顾性分析2012年12月~2015年11月在北京中医药大学东直门医院275例住院患者的临床资料,对纳入病例血清降钙素原超过0.5 ng/mL以及痰液、尿液、血液、脓液或咽拭子微生物培养阳性者的一般情况以及所在临床科室、血清降钙素原值、微生物培养标本采集部位、微生物培养结果分布情况、培养所得微生物分类进行分析,分析血清降钙素原与病原微生物的关系。结果患者所在临床科室以血液肿瘤科、重症监护室、急诊科为主;微生物培养标本采集部位以痰液及尿液为主,占80.73%;革兰阳性菌以金黄色葡萄球菌、屎肠球菌、粪肠球菌等为主,革兰阴性菌以鲍曼不动杆菌、大肠埃希菌、铜绿假单胞菌等为主,真菌以白假丝酵母菌、光滑假丝酵母菌、热带假丝酵母菌等为主。真菌培养阳性者血清降钙素原值低于细菌培养阳性者,差异有统计学意义(P<0.05),革兰阳性菌和革兰阴性菌血清降钙素原值比较,差异无统计学意义(P>0.05)。结论血清降钙素原对预测病原微生物具有重要意义,细菌感染者明显高于真菌感染者,但由于本研究条件所限,在预测革兰阳性菌和革兰阴性菌方面无阳性发现,尚需进一步深入研究。

Objective To explore the relationship between serum procalcitonin and pathogenic microorganisms. Methods From December 2012 to November 2015, clinical data from 275 cases of hospitalized patients in Dongzhimen Hospital, Beijing University of Chinese Medicine were selected retrospectively and the general information of the patients（the level of PCT0.5 ng/m L） with positive microbial cultivation of sputum, urine, blood, pus or throat swab and the department, level of PCT, collection site and distribution of the microbial culture, microbiological classification were analyzed. The relationship between serum procalcitonin and pathogenic microorganisms was anylyzed. Results The clinical departments was mainly in the blood oncology department, intensive care unit and emergency department; the collection site of the microbial culture were mainly from sputum and urine, accounted for 80.73%; Gram-positive bacteria mainly includes Staphylococcus aureus, Enterococcus faecium, Enterococcus faecalis and Gram-negative bacteria mainly includes Acineto-bacter baumannii, Escherichia coli, Pseudomonas aeruginosa, most of the Fungi were Candida albicans,Candida glabrata, Candida tropicalis. The level of PCT in fungi positive culture was lower than that of bacterial positive culture, with statistically significant difference（P〈0.05）. There was no statistically significant difference between Grampositive bacteria and Gram-negative bacteria in the level of PCT（P〈0.05）. Conclusions The level of PCT has significant meaning for predicting pathogenic microorganisms. Bacterial infections are significantly higher than those of the fungus. But due to the research conditions, there is no positive findings in the prediction of Gram-positive bacteria and Gram-negative bacteria. It needs further research.