内毒素及血浆1,3-β-D-葡聚糖检测在早期感染诊断中的应用  

Clinical application of endotoxin and plasma 1,3-β-D-glucan in diagnosis of early infections

作　　者：姜波 吕火祥[2] 

机构地区：[1]湖州市南浔区人民医院,浙江湖州313009 [2]浙江省人民医院医学检验中心,浙江杭州310014

出　　处：《中华医院感染学杂志》2014年第16期4152-4154,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然基金资助项目(Y2110743)

摘　　要：目的探讨血浆内毒素及1,3-β-D-葡聚糖检测在患者感染早期诊断中的应用,为临床资料提供参考依据。方法收集2012年l2月-2013年1月446例住院患者为研究对象,根据病原菌培养的结果将患者分为两组,培养阳性组52例和阴性组394例,比较两组中血浆内毒素及1,3-β-D-葡聚糖水平的差异,数据采用SPSS19.0统计软件处理。结果血培养阳性的患者血浆中的内毒素水平为(66.41±30.51)pg/ml,明显高于血培养阴性组的(9.62±3.31)pg/ml,且内毒素检测法阳性率为27.35%,高于血培养法的11.66%;同时真菌培养阳性患者血浆中的1,3-β-D-葡聚糖水平为(405.75±85.24)pg/ml,明显高于真菌培养阴性组(9.61±4.31)pg/ml,且1,3-β-D-葡聚糖检测法阳性率为40.81%,高于真菌培养法的10.31%,差异均有统计学意义(P<0.05)。结论血浆内毒素及1,3-β-D-葡聚糖的测定在革兰阴性菌及真菌感染的早期诊断中,具有一定的临床价值。OBJECTIVE To study the value of detection of endotoxin and plasma 1,3-β-D-g1 ucan in early diagnosis of infections in patients so as to provide reference for clinical data.METHODS A total of 446 patients who were hospitalized from Dec 2012 to Jan 2013 were enrolled in the study and divided into two group according to the result of culture of pathogens,the positive culture group with 52 cases and the negative culture group with 394 cases,then the levels of plasma endotoxin and 1,3-β-D-g1 ucan were observed and compared between the two groups,and the data were processed with the use of SPSS19.0 software.RESULTS The level of plasma endotoxin of the patients with positive blood culture was（66.41±30.51）pg/ml,significantly higher than（9.62±3.31）pg/ml of the patients with negative blood culture;the positive rate of the endotoxin detection method was 27.35%,higher than 11.66%of the blood culture method.The level of the plasma 1,3-β-D-g1 ucan of the patients with positive fungal culture was（405.75±85.24）pg/ml,significantly higher than（9.61±4.31）pg/ml of the patients with negative fungal culture;the positive rate of the 1,3-β-D-g1 ucan detection method was 40.81%,higher than10.31%of the fungal culture method,the difference was significant（P0.05）.CONCLUSION The determination of the level of plasma endotoxin or 1,3-β-D-g1 ucan may have certain clinical value in the early diagnosis of the infections caused by gram-negative bacteria or fungi.

关 键 词：内毒素 1 3-Β-D-葡聚糖 真菌 病原菌 感染 

分 类 号：R446[医药卫生—诊断学]