深部真菌感染脓毒症患者(1,3)-β-D葡聚糖的血浆水平变化  

Plasma(1,3) -β-D-Glucan Levels in Septic Patients with Fungal Infection

作　　者：陈秋萍[1] 张媛莉[2] 冯永民[3] 邓烈华[2] 

机构地区：[1]广东医学院附属医院老年病科,广东湛江524001 [2]广东医学院附属医院危重医学科,广东湛江524001 [3]广东医学院附属医院肾病内科,广东湛江524001

出　　处：《临床医学工程》2012年第2期182-184,共3页Clinical Medicine & Engineering

基　　金：广东省医学科研基金项目(A2009484)

摘　　要：目的探讨深部真菌感染脓毒症患者(1,3)-β-D-葡聚糖(BG)的血浆水平变化及与病情严重程度的关系。方法将67例脓毒症患者分为深部真菌感染组(11例)、二重感染组(G-菌合并真菌感染,36例)和革兰氏阴性(G-)菌感染组(20例),另选取20例健康志愿者(10男10女)为对照组。67例脓毒症患者24小时内进行急性生理和慢性健康状况(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分,同时采集血标本检测血浆BG浓度变化。结果与正常对照组相比较,脓毒症各组患者的血浆BG水平均显著升高(P<0.05);真菌感染组及二重感染组的血浆BG水平均显著高于G-感染组,而真菌感染组与二重感染两组之间的血浆BG水平相比较差异无统计学意义(P>0.05)。(真菌感染+二重感染组)患者血浆BG水平与APACHEⅡ评分呈正相关(r=0.325,P=0.043)。结论真菌感染脓毒症患者血浆BG水平显著升高,BG可能是影响真菌感染脓毒症患者病情的危险因素。Objective To investigate the plasma levels of （1, 3） -β-D-glucan （BG） in septic patients and their correlations with the severity of septic patients. Methods The septic patients were divided into three subgroups which were the deep fungal infection group （n=11）, the double infection group caused by fungi and Gram-negative bacteria （n=36） and the Gram-negative bacteria infection group （n=20）. Ten male and ten female healthy volunteers were selected for the control group. The clinical data including the acute physiology and chronic health conditions （APACHE） II score and sequential organ failure （SOFA） score were collected and recorded. Blood samples were collected. Plasma BG levels were detected and analyzed statistically. Results Plasma BG levels were all significantly higher in three septic groups as compared with group of healthy control （P〈0.05）. The plasma BG levels in group of double infection and group of fungal infection were significantly higher than those in group of Gram-negative bacteria infection （P 〈0.05）. There was no significant difference in plasma BG levels between group of double infection and group of ftmgal infection （P〉0.05）. The plasma BG levels were positively correlated with score of APACHE II and SOFA （r = 0.325, P = 0.043）. Conclusion BG levels are increased significantly in septic patients with fungal infection. BG may be a risk factor associated with the severity of septic patients with fimgal infection.

关 键 词：脓毒症 真菌感染 (1  3)-β-D葡聚糖 

分 类 号：R446.5[医药卫生—诊断学]