摘要
目的研究肝衰竭患者伴感染的临床特点及白细胞分化抗原14(CD_(14))和CD_(14)^(+)CD_(16)^(+)单核细胞与合并感染的关系。方法选取2020年6月一2022年12月河北医科大学第二医院收治的224例肝衰竭患者为研究对象,其中178例患者并发感染设为感染组,未感染患者设为未感染组;分析肝衰竭伴感染患者感染部位、病原菌情况,比较两组患者CD_(14)和CD_(14)^(+)CD_(16)^(+)单核细胞水平,并采用受试者工作特征(ROC)曲线分析CD_(14)和CD_(14)^(+)CD_(16)^(+)单核细胞对感染的诊断价值。结果肝衰竭感染患者共培养分离病原菌224株,其中革兰阳性菌36株,革兰阴性菌174株,真菌14株,以大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌为主;感染组外周血CD_(14)和CD_(14)^(+)CD_(16)^(+)单核细胞水平分别为(43.45土12.46)mg/L和(11.17±2.26)%均高于未感染组(P<0.05);ROC曲线分析显示,外周血CD_(14)和CD_(14)^(+)CD_(16)^(+)单核细胞诊断肝衰竭患者发生感染的截断值分别为15.64mg/L、9.76%,曲线下面积(AUC)分别为0.864、0.849。结论肝衰竭患者易伴发感染,病原菌主要为革兰阴性菌,其中感染患者外周血CD_(14)和CD_(14)^(+)CD_(16)^(+)单核细胞水平均高表达,对于感染具有良好的诊断价值。
OBJECTIVE To investigate the clinical features of concomitant infections in patients with liver failure and the relationship between leukocyte differentiation antigen 14(CD_(14)) and CD_(14)^(+)CD_(16)^(+) monocytes and coinfec-tion.METHODS Totally 224 patients with liver failure admitted to the Second Hospital of Hebei Medical University from Jun.2020 to Dec.2022 were selected as the study subjects,of which 178 patients with concomitant infections were assigned as the infected group,and those without infection were assigned as the uninfected group.The infection site and pathogenic bacteria of patients with liver failure and infection were analyzed.The levels of CD_(14) and CD_(14)^(+)CD_(16)^(+) monocytes in the two groups were compared,and the diagnostic value of CD_(14) and CD_(14)^(+)CD_(16)^(+) monocytes for infections was analyzed by receiver operating characteristic(ROC)curve.RESULTS Totally 224 strains of pathogenic bacteria were cultured and isolated from patients with liver failure and infection,including 36 strains of gram positive bacteria,174 strains of gram negative bacteria,and 14 strains of fungi,with Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa predominating.The levels of peripheral blood CD_(14) and CD_(14)^(+)CD_(16)^(+) monocytes in the infected group were(43.45±12.46)mg/L and(11.17±2.26)%,respectively,higher than those in the uninfected group(P<0.05).ROC curve analysis showed that the cutoff values of CD_(14) and CD_(14)^(+)CD_(16)^(+) monocytes in peripheral blood were 15.64 mg/L and 9.76%,respectively,and the area under the curve(AUC)were 0.864 and 0.849,respectively.CONCLUSION Patients with liver failure were prone to concomitant infections,and the pathogenic bacteria were mainly gram-negative,of which the peripheral CD_(14) and CD_(14)^(+)CD_(16)^(+) monocytes levels of infected patients were highly expressed,which had good diagnostic values for infections.
作者
侯冬藏
秦甜
平春荣
阮晓曼
何文英
田甘露
陈泽阳
周文婧
徐梦辉
HOU Dong-zang;QIN Tian;PING Chun-rong;RUAN Xiao-man;HE Wen-ying;TIAN Gan-lu;CHEN Ze-yang;ZHOU Wen-jing;XU Meng-hui(The Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第19期2933-2936,共4页
Chinese Journal of Nosocomiology
基金
河北省卫生健康委科研基金项目(20230546)。
