慢性咽炎患者咽部分泌物病原菌感染状况及血液中嗜酸性粒细胞和中性粒细胞表达情况分析

Analysis of pathogenic bacteria infection in pharyngeal secretions and expression of eosinophils and neutrophils in blood of patients with chronic pharyngitis

目的探讨慢性咽炎患者咽部分泌物病原菌感染状况及血液中嗜酸性粒细胞和中性粒细胞水平。方法选取2015年3月至2017年7月该院诊治的96例慢性咽炎患者为研究对象,取咽后壁分泌物进行细菌培养及药敏试验,同时利用全自动血常规分析仪检测所有患者嗜酸性粒细胞和中性粒细胞水平。结果所有患者中有44例报告细菌学异常,检出率为45.83%,共检出68株病原菌;单纯性分型、肥厚性分型和干燥性分型患者分别检出32株(47.06%),25株(36.76%)和11株(16.18%)菌株;慢性咽炎患者的病原菌种检出排在前3位的分别是α-溶血性链球菌(27.94%)、副流感嗜血菌(23.53%)和肺炎链球菌(16.18%);药物耐药性分析发现,青霉素、克林霉素和红霉素的耐药性最高,耐药率分别为63.24%、55.88%和44.12%。头孢他啶、头孢曲松和万古霉素的灵敏度较好,耐药率分别为17.65%、17.65%和0.00%;将检出病原菌的患者为观察组,并以未检出者为对照组,两组患者嗜酸性粒细胞水平比较,差异无统计学意义(P>0.05);但病原菌检出患者中性粒细胞水平明显低于对照组,差异有统计学意义(P<0.05)。结论慢性咽炎病原菌的检出率较高,病原菌的耐药性情况需要重视;慢性咽炎患者嗜酸性粒细胞水平与病原菌检出率无关,而低中粒性细胞水平患者病原检出率更高。

Objective To investigate the infection status of pathogenic bacteria in pharyngeal secretions of patients with chronic pharyngitis and the levels of eosinophils and neutrophils in blood.Methods A total of 96 patients with chronic pharyngitis diagnosed in our hospital from March 2015 to July 2017 were selected for the study.Bacteria culture and drug sensitivity test were performed on the posterior pharyngeal secretions.At the same time,eosinophil and neutrophil levels were detected by automatic hematology analyzer.Results The 44 cases of all patients reported bacterial abnormalities,the detection rate was 45.83%,were detected 68 cases of pathogens.The 32 cases（47.06%）,25 cases（36.76%）and 11 cases（16.18%）were detected in simple type,hypertrophic type and dry type,respectively.α-hemolytic streptococcus（27.94%）,haemophilus parainfluenzia（23.53%）and streptococcus pneumoniae（16.18%）were detected in the first three places of the pathogen of chronic pharyngitis.Drug resistance analysis found that penicillin,clindamycin and erythromycin resistance to the highest resistance rates were 63.24%,55.88%and 44.12%.Ceftazidime,ceftriaxone and vancomycin were better susceptibility,resistance rates were 17.65%,17.65% and 0.00%.There were no significant differences in eosinophil levels between the two groups（P〉0.05）.However,the patients with pathogens were not significantly different from those in the control group neutrophil level was significantly lower than the control group,the difference was statistically significant（P〈0.05）.Conclusion The detection rate of chronic pharyngitis pathogens is high and the drug resistance of pathogenic bacteria needs to be paid attention to.The level of eosinophil in patients with chronic pharyngitis has nothing to do with the detection rate of pathogens,and the detection rate of low neutrophil level is higher.