摘要
目的检测脓毒症患者感染病原菌分布特征、肝功能及血清中相关因子水平,并分析其临床意义。方法收集2015年3月至2018年3月于在本院接受治疗的脓毒症患者120例为观察组,同一时期来本院体检的健康志愿者120例为对照组。采集观察组患者血液标本进行细菌培养,分析其病原菌分布特点;采受者静脉血,分离血清,测定肝功能指标及相关功能因子,比较两组患者血清中谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、总胆汁酸(TBA)、可溶性髓系细胞触发受体-1(sTREM-1)及N端前体脑钠肽(NT-pro BNP)水平。结果 120例脓毒症患者共检出病原菌129株,其中革兰阳性菌48株(占37.21%),以金黄色葡萄球菌及凝固酶阴性葡萄球菌为主;革兰阴性菌71株(占55.04%),以大肠埃希菌和肺炎克雷伯菌为主;真菌10株(占7.75%)。观察组患者血清中ALT、AST、TBIL、TBA、sTREM-1及NT-pro BNP分别为(94.84±9.01)U/L、(115.36±10.34)U/L、(19.76±1.43)μmoL/L、(13.76±1.23)μmoL/L、(213.54±22.68)pg/mL和(97.36±9.54)ng/mL,对照组分别为(20.55±2.07)U/L、(22.23±2.39)U/L、(9.65±0.98)μmoL/L、(5.65±0.62)μmoL/L、(53.02±5.41)pg/mL和(35.29±3.61)ng/mL,差异均有统计学意义(P<0.05)。结论脓毒症患者感染病原菌分布广泛,主要以革兰阴性菌为主;脓毒症患者常出现肺功能受损及血清中相关因子水平异常。血液细菌培养阳性和血清sTREM-1、NT-pro BNP水平增高可作为脓毒症诊断及治疗用药的重要参考。
Objectives To determine the distribution of pathogens, liver function, and serum levels of related factors in patients with sepsis and to analyze their clinical significance. Methods A total of 120 patients with sepsis treated at this Hospital from March 2015 to March 2018 served as the observation group. One hundred and twenty healthy volunteers undergoing a physical at this Hospital during the same period served as the control group. Blood samples were collected from patients in the observation group for microbial culture, and characteristics of the distribution of pathogens were analyzed. The serum levels of ALT, AST, TBIL, TBA, sTREM-1, and NT-pro BNP in the two groups were compared. Results A total of 129 strains of pathogens were detected from the 120 patients with sepsis. Of those strains, 48(37.21%) were strains of Gram-positive bacteria, which were mainly Staphylococcus aureus and coagulase-negative staphylococcus, 71(55.04%) were strains of Gram-negative bacteria, which were mainly Escherichia coli and Klebsiella pneumoniae, and 10(7.75%) were strains of fungi. In the observation group, serum ALT was 94.84±9.01 U/L, serum AST was 115.36±10.34 U/L, serum TBIL was 19.76±1.43 umoL/L, serum TBA was 13.76±1.23 umoL/L, serum sTREM-1 was 213.54±22.68 pg/mL, and serum NT-pro BNP was 97.36±9.54 ng/mL. In the control group, serum ALT was 20.55±2.07 U/L, serum AST was 22.23±2.39 U/L, serum TBIL was 9.65±0.98 umoL/L, serum TBA was 5.65±0.62 umoL/L, serum sTREM-1 was 53.02±5.41 pg/mL, and serum NT-pro BNP was 35.29±3.61 ng/mL. Serum levels differed significantly(P<0.05). Conclusion A wide variety of pathogens infected patients with sepsis;those pathogens were mainly Gram-negative bacteria. Pulmonary dysfunction and abnormal serum levels of related factors are often found in patients with sepsis. A positive blood microbial culture and increased serum levels of sTREM-1 and NT-pro BNP can serve as an important reference for diagnosis and treatment of sepsis.
作者
张韬
张丽娟
王红霞
ZHANG Tao;ZHANG Li-juan;WANG Hong-xia(Infectious Disease Center, The First Hospital Affiliated with Xinjiang Medical University,Urumqi, Xinjiang, China 830054;Gastroenterology, Changji People's Hospital,Changji, Xinjiang, China 831100)
出处
《中国病原生物学杂志》
CSCD
北大核心
2019年第6期710-712,共3页
Journal of Pathogen Biology
基金
新疆重大疾病医学重点实验室开放课题(No.SKLIB-XJMDR-2014-2)
