鲍曼不动杆菌感染与急性胰腺炎患者病情程度的相关性研究

Study on the relationship between Acinetobacter baumannii infection and the severity of acute pancreatitis

目的观察急性胰腺炎(AP)患者鲍曼不动杆菌(AB)感染情况,并分析AB感染与患者病情程度的相关性,为指导AP患者病情程度的早期评估提供依据。方法回顾分析,收集2018年1月-2020年6月商丘市中心医院完成治疗及随访的89例AP患者资料,参照相关评分标准评估患者病情严重程度并分组;采集患者基线资料,比较患者各项实验室指标,并根据细菌培养及药敏结果比较两组AB感染情况,分析AB感染与AP患者病情程度的关系。结果89例AP患者急性生理与慢性健康评估(APACHEⅡ)评分结果显示,轻型患者57例,重型患者32例;重型患者AB感染率、降钙素原(PCT)、C反应蛋白(CRP)表达均高于轻型患者(P<0.05);经单项Logistic回归分析后建立多元回归模型,结果显示,AB感染及血清CRP过表达是AP患者病情加重的影响因素(OR>1,P<0.05),其中AB感染带来的影响最为显著,可能作为独立危险因素;绘制ROC曲线,AB感染预测AP患者病情程度加重风险的AUC为0.800,具有一定预测价值。结论AP患者若检出AB感染,可能提示病情程度有加重风险,早期鉴别患者AB感染情况,对指导临床预测、干预AP病情进展有一定积极意义。

Objective To observe Acinetobacter baumannii infection in patients with acute pancreatitis(AP),and to analyze the correlation between Acinetobacter baumannii infection and the patient’s condition,so as to provide evidence for guiding the early assessment of the condition of AP patients.Methods Retrospectively analyzed,the data of 89 AP patients who completed treatment and follow-up in Shangqiu Central Hospital from January 2018 to June 2020 were collected,and according to the relevant scoring standards,assessed the severity of the patient’s condition and grouped them;collected baseline data of patients,compared various laboratory indicators of patients,according to the results of bacterial culture and drug sensitivity,the condition of Acinetobacter baumannii infection of the two groups was compared,and the relationship between Acinetobacter baumannii infection and the severity of AP patients was analyzed.Results After 89 AP patients who underwent the Acute Physiology and Chronic Health Assessment(APACHEⅡ)scoring,the assessment results showed that there were 57 cases of mild patients and 32 cases of severe patients;the infection rate of Acinetobacter baumannii,procalcitonin(PCT),and C-reactive protein(CRP)expression in severe patients were higher than those in mild patients(P<0.05);after a single logistic regression analysis,a multiple regression model was established,and the results showed that Acinetobacter baumannii infection and overexpression of serum CRP were the influencing factors for the aggravation of AP patients(OR>1,P<0.05),among them,Acinetobacter baumannii infection had the most significant impact,which might be an independent risk factor;the ROC curve was drawn,the AUC of Acinetobacter baumannii infection predicting the risk of exacerbation of AP patients was 0.800,which had certain predictive value.Conclusion If Acinetobacter baumannii infection is detected in an AP patient,it may indicate a risk of aggravation of the condition.Early identification of patients with Acinetobacter baumannii infection has a certain positive significance in guiding clinical prediction and intervention in the progression of AP.