新生儿重症肺炎合并脓毒症患儿血清PCT、Lac及内毒素水平对医院感染的影响

Effects of serum PCT, Lac and Endotoxin levels on Nosocomial infection in newborn with Severe neumonia combined with Sepsis

目的探讨新生儿重症肺炎合并脓毒症患儿血清降钙素原(PCT)、血乳酸(Lac)及内毒素水平对医院感染的影响,为新生儿重症肺炎合并脓毒症的临床诊治提供参考。方法选取2017年8月-2018年7月在医院住院的重症肺炎合并脓毒症新生儿60例,检测血清PCT、Lac及内毒素水平,同时观察医院感染发生情况。结果共有32例患儿住院期间发生医院感染,感染率为53.33%,其中12例泌尿道、8例皮肤黏膜、6例呼吸道、4例胃肠道,分别占37.50%、25.00%、18.75%、12.50%;发生医院感染患儿血清PCT、Lac及内毒素水平分别为(26.93±4.72)ng/ml、(8.15±1.15)mmol/L、(19.75±4.79)pg/ml,高于无医院感染患儿(21.79±6.28)ng/ml、(6.10±1.06)mmol/L、(15.77±3.84)pg/ml,比较差异有统计学意义(P<0.05);医院感染患儿死亡率为31.25%,无医院感染死亡率为7.14%,比较差异有统计学意义(P<0.05)。结论新生儿重症肺炎合并脓毒症患儿血清PCT、Lac及内毒素水平与医院感染关系密切,医院感染患儿以上指标明显高于未发生医院感染患儿,发生医院感染的患儿预后更差。

Objective To investigate the of serum procalcitonin(PCT),lactic acid(Lac)and endotoxin levels on nosocomial infection in newborn with severe pneumonia combined with sepsis,it provides reference for the clinical diagnosis and treatment of severe pneumonia complicated with sepsis.Methods We selected 60 cases newborn with severe pneumonia combined with sepsis from August 2017 to July 2018,to measured serum PCT,Lac and endotoxin levels and observed nosocomial infection.Results All of the32 cases newborn were nosocomial infection,the infection rate was 53.33%,there were 12 cases of urinary tract and 8 cases of skin mucosa,6 cases of respiratory tract and 4 cases of gastrointestinal tract,accounting for 37.50%,25.00%,18.75% and 12.50% respectively.PCT were(26.93±4.72)ng/ml,Lac were(8.15±1.15)mmol/L,endotoxin were(19.75±4.79)pg/ml of nosocomial infection newborn,PCT were(21.79±6.28)ng/ml,Lac were(6.10±1.06)mmol/L,endotoxin were(15.77±3.84)pg/ml of without nosocomial infection newborn,the difference was statistically significant(P<0.05).The mortality rate was 31.25% in nosocomial infection newborn,7.14% in without nosocomial infection newborn,the difference was statistically significant(P<0.05).Conclusion The serum PCT,Lac and endotoxin levels of nosocomial infection severe were closely related of pneumonia combined with sepsis,the above indicators were significantly higher in newborn with nosocomial infection than those without nosocomial infection,newborn with nosocomial infections have worse outcomes.