摘要
目的 观察慢性肾衰竭维持性血液透析患者肺部细菌感染时中性粒细胞CD64（nCD64）指数与血清降钙素原（PCT）浓度的变化,评价nCD64指数与血清PCT浓度在诊疗过程中的价值.方法 选择2012年11月至2016年11月收治的53例合并肺部细菌感染的慢性肾衰竭维持性血液透析患者（感染组）,另选择56例同期维持性血液透析非感染者（未感染组）、50例健康体检者（正常对照组）.分析感染组致病菌分布情况,比较感染组、未感染组及正常对照组nCD64指数和血清PCT浓度的差别,对比感染组治疗前后nCD64指数和血清PCT浓度的变化.结果 感染组痰培养出致病菌53株,其中,革兰阴性杆菌17株（32.08％）,革兰阳性球菌36株（67.92％）.治疗前感染组、未感染组、正常对照组nCD64指数分别为4.13±0.43、0.82±0.08、0.78±0.08,PCT浓度分别为（3.64±0.29）、（0.45±0.04）、（0.45±0.04） μg/L,差异均有统计学意义（P＜ 0.01）.感染组治疗后nCD64指数与血清PCT浓度显著降低[0.86±0.09比4.13±0.43,（0.74±0.07） μg/L比（3.64±0.29）μg/L],与治疗前比较差异有统计学意义（P＜0.01）.结论 nCD64指数、血清PCT浓度是判断维持性血液透析患者发生肺部细菌性感染的敏感指标,为慢性肾衰竭维挣性血液透析合并肺部细菌感染的治疗评估提供重要依据.
Objective To observe the changes of neutrophil CD64 （nCD64） index and serum procalcitonin （PCT） in hemodialysis patients with bacterial pneumonia,and to evaluate the effect of these two indicators in the course of diagnosis and treatment.Methods Fifty-three cases of bacterial pneumonia undergoing hemodialysis were enrolled in this study from November 2012 to November 2016 （infection group）.At the same time,56 patients undergoing hemodialysis without bacterial infection （noninfection group） and fifty volunteers （control group） were also enrolled.The infection pathogen distribution,changes of nCD64 index and serum PCT in three groups were analyzed.And the changes of nCD64 index and serun.PCT before and after treatment in the infection group were analyzed too.Results Totally 53 strains of pathogens in the infection group were isolated,including 36 strains of gram-positive bacteria （accounting for 67.92％） and 17 strains of gram-negative bacteria （accounting for 32.08％）.The nCD64 index of infection group,non-infection group and control group were as following：4.13 ± 0.43,0.82 ± 0.08 and 0.78 ± 0.08,and the serum PCT levels of infection group,non-infection group and control group were as following：（3.64 ± 0.29）,（0.45 ± 0.04） and （0.45-± 0.04） μg/L.There were significant differences （P ＜ 0.01）.The nCD64 index before and after treatment of infection group were 4.13 ± 0.43 and 0.86 ± 0.09.And serum PCT level before and after treatment of infection group were （3.64 ± 0.29） and （0.74 ± 0.07） μg/L.There were significant differences （P＜0.01）.Conclusions The nCD64 index and serum PCT are sensitive indicators to determine the happening of bacterial pneumonia in patients undergoing hemodialysis,and it provides critical evidence for the evaluation of treatment in patients.
出处
《中国医师进修杂志》
2017年第4期337-340,共4页
Chinese Journal of Postgraduates of Medicine
