脂多糖水平在革兰阴性菌感染的早期诊断中的应用价值

Value of lipopolysaccharide in the early diagnosis of Gram-negative bacteria infection

目的研究并探讨脂多糖水平在革兰阴性菌感染早期诊断中的应用价值。方法选择我院2016年1月至2016年6月收治的疑似革兰阴性菌感染患者80例作为观察组,另选择同期体检健康者30例作为对照组,对观察组患者进行细菌培养和血浆LPS检测,以细菌培养作为金标准,计算血浆LPS检测的特异度、灵敏度和准确率;同时,检测对照组的血浆LPS水平,并与观察组进行比较。结果 LPS检测的诊断阳性率为86.25%,明显高于细菌培养的75.00%,差异具有统计学意义(P<0.05)。LPS检测对革兰阴性杆菌感染的诊断灵敏度、特异度、准确率分别为96.67%、45.00%、83.75%,阳性预测值为84.06%,阴性预测值为81.82%。观察组60例细菌培养阳性者的LPS含量为(160.65±79.52)pg/m L,明显高于对照组的(8.63±3.49)pg/m L,差异具有统计学意义(P<0.05)。结论 LPS水平检测有助于对革兰阴性杆菌感染患者进行早期诊断,且诊断准确率高,具有较高的临床应用价值。

Objective To study and evaluate the value of lipopolysacc haride（LPS） level in the early diagnosis of gramnegative bacterial infection. Methods Eighty patients with suspected Gram-negative bacilli who were admitted in our hospital from January 2016 to June 2016 were selected as the observation group, 30 cases subjects with physical examination in the same period were selected as the control group. Bacteria culture and plasma LPS were measured in the observation group, and the specificity, sensitivity and accuracy of plasma LPS were calculated by using bacterial culture as gold standard. At the same time, plasma LPS level was measured in the control group and compared with that of the observation group. Results The positive rate of LPS detection was 86.25%, which was significantly higher than 75.00% of bacterial culture, the difference was statistically significant（P〈0.05）. The diagnostic sensitivity, specificity and accuracy of LPS for Gram-negative bacilli were 96.67%, 45.00% and 83.75% respectively, the positive predictive value was 84.06%and the negative predictive value was 81.82%. The LPS content of 60 bacterial culture positive patients in the observation group was（160.65±79.52） pg/m L, which was significantly higher than（8.63±3.49） pg/m L of the control group（P〈0.05）.Conclusion LPS level detection is helpful for the early diagnosis in patients with Gram-negative bacilli, with high diagnostic accuracy and clinical value.