呼吸机相关肺炎肺泡灌洗液标志物检测的意义

Significance of detection of alveolar lavage fluid in patients with ventilator-associated pneumonia

目的探讨肺泡灌洗液中降钙素原(PCT)、载脂蛋白E(Apo E)、尼克酰胺磷酸核糖转移酶(Nampt)对呼吸机相关肺炎的诊疗作用。方法将机械通气患者(31人)根据呼吸机相关肺炎(VAP)的诊断标准分为VAP组(23人),非VAP组(8人)。根据VAP组治疗效果情况,将患者分为好转组(14人)与恶化组(9人)。分别于机械通气24h、96h、144h取灌洗液标本。并检测血清及灌洗液中PCT、载脂蛋白E、尼克酰胺磷酸核糖转移酶水平。结果 VAP组灌洗液PCT、Appo E水平较非VAP组有所增高,恶化组灌洗液PCT、Appo E水平较好转组有所增高,灌洗液中Nampt水平变化无统计学意义。结论检测肺泡灌洗液PCT、Apo E水平有助于呼吸机相关肺炎的早期诊断和疗效判断。

Objective To investigate the diagnosis and treatment effect of PCT, ApoE and Nampt in bronchoalveolar lavage fluid on ventilator-associated pneumonia. Methods According to the VAP diagnostic criteria, the patients were divided into the VAP group and the non-VAP group. The VAP group was divided into the improvement group and the deterioration group. The lavage fluid samples were taken at 24h, 96h and 144h after mechanical ventila- tion, and the levels of PCT, ApoE and Nampt levels were measured. Results The levels of PCT and ApoE in the lavage fluid of the non-VAP group were higher than those of the VAP group. The levels of PCT and ApoE in the deterioration group were higher than those of the improvement group. The level of Nampt in lavage fluid was not statistically significant. Conclusion The detection of PCT, ApoE and Nampt in bronchoalveolar lavage fluid is helpful for the early diagnosis and treatment of ventilator-associated pneumonia.