血小板及其参数在细菌、真菌及病毒感染治疗前后的变化分析

Analysis of platelet and its parameters before and after treatment with bacterial,fungal and viral infections

目的探讨血小板各指标在机体感染治疗前后变化及其在鉴别各型病原体感染中的作用。方法选取2015年1月至2017年2月本院收治的各种病原体感染患者115例,按感染的病原体类型分为革兰阴性杆菌败血症组(n=36),革兰阳性球菌败血症组(n=20),局部组织细菌感染组(n=16),真菌感染组(n=12),病毒感染组(n=31),并以50名健康体检者作为对照组。比较治疗前后各组血小板计数(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)及大血小板比例(P-LCR)的变化。结果治疗前,各感染组血小板各指标与对照组比较差异无统计学意义。治疗后,革兰阴性杆菌败血症组、革兰阳性球菌败血症组、局部组织细菌感染组及真菌感染组血小板计数较治疗前明显增加,差异有统计学意义(P<0.05)。病毒感染组治疗前后血小板计数比较差异无统计学意义。治疗后,局部组织细菌感染组MPV、PDW、P-LCR均低于治疗前,差异有统计学意义(P<0.05)。治疗后,病毒感染组MPV、P-LCR明显高于治疗前(P<0.05);真菌感染组治疗前后MPV、PDW、PLCR比较差异无统计学意义。结论机体发生感染时,血小板及参数在病原体种类鉴别及临床治疗方面具有一定的指导作用。

Objective To explore the changes of platelet indexes before and after treatment of body infection and its role of inidentifying pathogen types in infection.Methods From January 2015 to February 2017,115 patients with various pathogens infection in our hospital were selected.According to the type of pathogen,there were divided into Gram-negative bacilli septicemia group(n=36),Gram-positive cocci septicemia group(n=20),local tissue bacterial infection group(n=16),fungal infection group(n=12)and viral infection group(n=31),50 healthy subjects were selected as the control group.The changes of platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),and large platelet ratio(P LCR)in each group were compared before and after treatment.Results Before treatment,there was no significant difference in the platelet indexes between the infection groups and the control group.After treatment,platelet count of Gram-negative bacilli septicemia group,Grampositive cocci septicemia group,local tissue bacterial infection group and fungal infection group increased significantly compared with before treatment,with statistical significance(P<0.05).There was no significant difference in the platelet count of the virus infection group before and after treatment.After treatment,MPV,PDW and P-LCR of local tissue bacterial infection group were all lower than before treatment,with statistical significance(P<0.05).After treatment,MPV and P-LCR of virus infection group were significantly higher than those before treatment(P<0.05).There was no significant difference in MPV,PDW and P-LCR of the fungal infection group before and after treatment.Conclusion When the body is infected,platelet and its parameters have a certain guiding role in the identification of pathogens and clinical treatment.