D二聚体、纤维蛋白降解产物和降钙素原在不同细菌感染引起的脓毒血症中的诊断价值

Diagnostic Value of D-dimer,Fibrin Degradation Products and Procalcitonin in Sepsis Caused by Different Bacterial Infections

目的探讨二聚体(D-D)、纤维蛋白降解产物(FDP)和降钙素原(PCT)在不同细菌感染引起的脓毒血症中的诊断价值。方法以100例脓毒症患者为对象,根据实验室细菌培养将100例患者分为鲍曼不动杆菌组(n=16)、大肠埃希菌组(n=38)、肺炎克雷伯菌组(n=24)、金黄色葡萄球菌组(n=22)。以同期30例健康体检者为对照组。检测各组炎症及凝血指标水平。结果各感染组患者白细胞计数(WBC)、FDP、D-D、PCT水平高于对照组,活化部分凝血活酶时间(aPTT)、凝血酶原时间(PT)延长,抗凝血酶(AT)活性降低(P<0.05);凝血酶时间(TT)比较无差异(P>0.05)。大肠埃希菌组患者PCT、FDP、D-D升高幅度较其他感染组明显(P<0.05)。D-D、FDP及PCT均可有效的区别大肠埃希菌与鲍曼不动杆菌、肺炎克雷伯菌、金黄色葡萄球菌感染引起的脓毒血症(P<0.05)。结论脓毒血症患者FDP、D-D及PCT水平均升高,利用三者可较好的鉴别大肠埃希菌感染。

Objective To investigate the diagnostic value of D-D,FDP and PCT in sepsis caused by different bacterial infections.Methods 100 patients with sepsis were divided into Acinetobacter baumannii group(n=16),Escherichia coli group(n=38),Klebsiella pneumoniae group(n=24)and Staphylococcus aureus group(n=22).30 healthy people were selected as control group.The levels of inflammation and coagulation indexes were detected.Results White blood cell count(WBC),FDP,D-D,PCT levels in the infection groups were higher than those in the control group,the activated partial prothrombin time(aPTT),prothrombin time(PT)were prolonged,antithrombin(AT)activity was decreased(P<0.05);there was no difference in thrombin time(TT)(P>0.05).PCT,FDP and D-D in E.coli group were significantly higher than those in other infection groups(P<0.05).D-D,FDP and PCT could effectively distinguish sepsis caused by Escherichia coli and Acinetobacter baumannii,Klebsiella pneumoniae and Staphylococcus aureus(P<0.05).Conclusion The levels of FDP,D-D and PCT in patients with sepsis are increased,which can be used to identify Escherichia coli infection.