常规检验及治疗与急性感染性腹泻病原学诊断的关系

Relationship of routine examinations and treatment with the etiological diagnosis of acute infectious diarrhea

目的分析急性感染性腹泻患者的血常规、粪常规检验结果及治疗方案与病原学诊断的关系,为感染性腹泻的临床诊疗提供参考依据。方法收集962例急性感染性腹泻患者的临床样本,鉴定病原体,并进行血常规和粪常规检验,分析血常规、粪常规检验结果及治疗方案与急性感染性腹泻病原学诊断结果的关系。结果从962例急性感染性腹泻患者的粪便样本中分离出病原体295例,其中细菌239例、病毒56例。血常规检验结果中,细菌性腹泻与病毒性腹泻患者的白细胞(WBC)计数、中性粒细胞百分比(NE%)以及NE%和淋巴细胞百分比(LYM%)异常者所占比例差异有统计学意义(P<0.05);粪常规检验结果中,病毒性腹泻患者发生水样便的比例明显高于细菌性腹泻患者(P=0.002),而发生黏液便的比例明显低于细菌性腹泻患者(P=0.049)。临床经验用药与患者病原学诊断结果的符合率为72.2%(213/295)。结论常规检验对急性感染性腹泻的诊疗有一定的参考价值,但应进行更准确、全面的病原学检测,以便为临床诊疗提供更精准的参考依据。

Objective To analyze the relationship of routine examinations and treatment with the etiologicaldiagnosis of acute infectious diarrhea,and to provide a reference for the diagnosis and treatment of acute infectiousdiarrhea. Methods Totally,962 specimens of acute infectious diarrhea patients were collected,and the pathogenswere identified. Blood routine examination and stool routine examination were performed. The relationship of theresults of blood routine examination and stool routine examination and treatment with the etiological diagnosis wasanalyzed. Results A total of 295 pathogens,including 239 bacteria and 56 viruses,were determined from 962specimens. There was statistical significance for the abnormal proportions of white blood cell （WBC） count,neutrophil percentage （NE%）,abnormal NE% and lymphocyte percentage （LYM%） between patients infectedwith bacteria and viruses（P〈0.05）. The proportion of water stool was higher in patients infected with viruses thanthat in patients infected with bacteria （P=0.002）,and the proportion of mucous stool was higher in patients infectedwith bacteria （P=0.049）. The consistency rate was 72.2%（213/295） between empirical treatment and pathologicaldiagnosis results. Conclusions The routine examinations could provide a reference for the diagnosis and treatment ofacute infectious diarrhea,while accurate and comprehensive pathogenic determination is also needed for its preciousclinical diagnosis and treatment.