呼吸机相关性肺炎病人的病原菌分布与C-反应蛋白及降钙素原水平的影响探析  

Influence of pathogens distribution on C-reactive protein and procalcitonin level in patients with ventilator-associated pneumonia

作　　者：吴苏宏[1] WU Su-hong(The basic medicine Department of Career Academy in Zhangzhou,Zhangzhou ,Fujian ,363000,China)

机构地区：[1]漳州卫生职业学院基础医学部,福建363000

出　　处：《齐齐哈尔医学院学报》2018年第18期2113-2115,共3页Journal of Qiqihar Medical University

摘　　要：目的探究呼吸机相关性肺炎患者病原菌分布情况,并对呼吸机相关性肺炎患者C-反应蛋白(CRP)及降钙素原(PCT)水平进行分析,为临床提供指导。方法随机抽取2015年11月—2018年4月我院135例使用呼吸机治疗患者(观察组)为观察对象,对135例患者临床资料进行回顾性分析,结合是否合并感染将其分为感染组(85例)、未感染组(50例),同时,选取同时间段50名来我院行健康体检者作为对照组。对感染组患者的病原菌分布情况进行分析,并对所有研究对象实施CRP、PCT水平检测,分析对比观察组患者和对照组体检者C-反应蛋白及降钙素原水平。结果共分离出124株病原菌,其中70株为革兰阴性杆菌,占比为56.45%(70/124),46株为革兰阳性球菌,占比为37.10%(46/124),8株为真菌,占比为6.45%(8/124),革兰阴性杆菌所占比显著高于其他病原菌,具有统计学意义(P<0.05);观察组患者C-反应蛋白[(0.65±0.23) mg/L]、降钙素原[(0.58±0.12)μg/L]相比对照组[(0.21±0.05) mg/L、(0.19±0.05)μg/L]明显更高,P<0.05;感染组患者C-反应蛋白[(0.72±0.25) mg/L]、降钙素原[(0.62±0.23)μg/L]相比未感染组[(0.48±0.10) mg/L、(0.42±0.10)μg/L]明显更高,P<0.05。结论呼吸机相关性肺炎患者病原菌以革兰阴性杆菌为主,如大肠埃希菌、鲍氏不动杆菌等;呼吸机相关性肺炎患者C-反应蛋白及降钙素原水平均会出现明显升高,可将C-反应蛋白及降钙素原水平作为诊断病情及评估治疗效果的有效指标。Objective To explore the distribution of pathogenic bacteria in patients with ventilator-associated pneumonia,and to analyze the levels of C-reactive protein( CRP) and procalcitonin( PCT) in patients with ventilator-associated pneumonia,in order to provide guidance for clinical practice. Methods 135 cases of ventilator treated patients( observation group) were randomly selected from November 2015 to April2018. The clinical data of the 135 patients were analyzed retrospectively. Combined with infection or not,the patients were divided into infection group( 85 cases) and uninfected group( 50 cases). At the same time,50 health volunteers of the same period were selected from our hospital as the control group. The distribution of pathogenic bacteria in the infected group was analyzed,and the CRP and PCT level of all the subjects were tested,and the level of C-reactive protein and procalcitonin in the patients of the observation group and the control group were analyzed.Results 124 strains of pathogenic bacteria were isolated,of which 56. 45%( 70/124) were gram-negative bacilli,37.10%( 46/124) strains of gram-positive cocci,6.45%( 8/124) of fungi,and proportion of gram-negative bacilli were significantly higher than the other pathogenic bacteria( P < 0. 05).The concentration of C-reaction protein( 0. 65 ± 0. 23 mg/L) and procalcitonin( 0. 58 ± 0. 12 μg/L) of the observation group were higher than the control group [( 0.21±0.05) mg/L,( 0.19±0.05) μg/L],P<0.05. Levels of C-reaction protein and procalcitonin [( 0. 72 ± 0. 25]) mg/L,( 0. 62 ± 0. 23) μg/L〗 of infection group were significantly higher than those in non-infected group( 0. 48 ± 0. 10) mg/L,( 0. 42 ± 0. 10) μg/L〗,P < 0. 05.Conclusions The pathogenic bacteria of ventilator-associated pneumonia are mainly gram-negative bacilli,such as Escherichia coli and Acinetobacter baumannii. The concentration of C-reactive protein and procalcitonin in the patients with ventilator associated pneumonia will increase significantly,and the C-reactive protein and

关 键 词：呼吸机相关性肺炎 病原菌 C-反应蛋白 降钙素原 

分 类 号：R563[医药卫生—呼吸系统]