文章摘要
明颖.多项炎症因子联合监测对细菌性脓毒症的辅助诊断作用[J].安徽医药,2019,23(3):491-494.
多项炎症因子联合监测对细菌性脓毒症的辅助诊断作用
Analysis of combined monitoring of multiple inflammatory factors in the diagnosis of bacterial sepsis
投稿时间:2017-11-20  
DOI:
中文关键词: 细菌性脓毒症  降钙素原  C反应蛋白  白细胞介素-27  急性生理学与慢性健康状况评分系统Ⅱ
英文关键词: Bacterial sepsis  Procalcitonin  C reactive protein  Interleukin -27  Acute physiology and chronic health scoring system Ⅱ
基金项目:承德市科学技术研究与发展计划(201606A052)多项炎症因子联合监测对细菌性脓毒症的辅助诊断作用明颖 (承德医学院附属医院检验科,河北 承德 067000)
作者单位
明颖 承德医学院附属医院检验科,河北 承德 067000 
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中文摘要:
      目的 研究多项炎症因子联合监测对细菌性脓毒症的辅助诊断作用。 方法 回顾性分析2014年1月至2016年12月于承德医学院附属医院接受治疗的细菌性脓毒症病人80例为研究对象,根据病人感染情况不同分为革兰阳性菌脓毒组48例、革兰阴性菌脓毒症组32例。另取同期接受体检的健康人30例为健康对照组。分别采用免疫发光分析法、免疫速率散射比浊法以及酶联免疫吸附法检测各组血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-27(IL-27)水平,同时计算急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)与序贯器官衰竭估计(SOFA)评分。比较三组血清学指标水平以及APACHEⅡ、SOFA评分,并作相关性分析。另外,将细菌性脓毒症病人根据治疗后生存状况分为死亡组与存活组,比较两组病人血清PCT、CRP、IL-27水平及APACHEⅡ、SOFA评分。并作多因素Logistic回归分析。 结果 革兰阴性菌脓毒症组血清PCT、CRP、IL-27水平以及APACHEⅡ、SOFA评分明显高于革兰阳性菌脓毒症组,而革兰阳性菌脓毒症组明显高于健康对照组(均P<0.05)。经Preason相关性分析可得:脓毒症病人血清PCT、CRP、IL-27水平与APACHEⅡ、SOFA评分均呈正相关(均P<0.05)。死亡组血清PCT、IL-27、CRP水平与APACHEⅡ、SOFA评分均明显高于存活组(均P<0.05)。经多因素logistic回归分析可得:PCT、CRP、IL-27以及APACHEⅡ评分均为影响细菌性脓毒症病人预后的独立危险因素(均P<0.05)。 结论 联合检测血清PCT、CRP、IL-27水平以及计算APACHEⅡ、SOFA评分可诊断细菌性脓毒症,并可有效评估病人预后。
英文摘要:
      Objective To study the effect of combined monitoring of multiple inflammatory factors in the diagnosis of bacterial sepsis and to analyze the effect. Methods A retrospective analysis from January 2014 to December 2016 in our hospital patients with bacterial sepsis treatment of 80 cases as the research object, According to the patient′s infection, there were 48 cases of Gram-positive bacteria sepsis group and 32 cases of Gram-negative bacteria sepsis group.Another 30 cases of healthy people underwent physical examination in our hospital were chosen as healthy control group.Detected by fluorescent analysis method,serum immune rate nephelometry and ELISA method to detect two groups of procalcitonin (PCT),C reactive protein (CRP),interleukin -27 (IL-27) level and calculate the acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) score.The serological index level and APACHE Ⅱ sofa score were compared among the three groups,and the correlation analysis was made.Patients with bacterial sepsis were divided into death group and survival group according to their survival status after treatment.The serum PCT,CRP,IL-27,and APACHE level Ⅱ,SOFA score and multiple regression analysis were compared.The factors of Logistic was performed. Results Gram-negative bacteria sepsis group serum PCT,CRP,IL-27 levels and APACHEII,SOFA scores were significantly higher than Gram-positive bacteria sepsis group,while Gram-positive bacteria sepsis group was significantly higher than healthy control group.(P<0.05).The Preason correlation analysis:sepsis serum PCT,CRP,IL-27 and APACHE Ⅱ,SOFA score were positively correlated (P<0.05).The death group of serum PCT,IL-27,CRP and APACHE Ⅱ,SOFA scores were significantly higher than the survival group (P<0.05).Multivariate Logistic regression analysis:PCT,CRP,IL-27 and APACHE score were independent prognostic risk factors in patients with bacterial sepsis (all P<0.05). Conclusion The combined detection of serum PCT,CRP,IL-27 levels and APACHE Ⅱ,SOFA score can be used to diagnose bacterial sepsis,which can effectively evaluate the prognosis of patients.
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