肝硬化合并革兰阳性和阴性细菌感染患者的血清降钙素原水平研究  

Study on serum PCT level in patients with liver cirrhosis complicating Gram positive and Gram negative bacterial infection

作　　者：王晗[1] 杨宁[1] 李妍[1] 李沛然[1] 谢娜[2] 苑雯文 耿伟[1] 何叶莉 郭桐生[1] 

机构地区：[1]解放军第三〇二医院临床检验医学中心/全军感染病临床实验诊断中心,北京100039 [2]解放军第三〇二医院感染性疾病研究与诊疗中心,北京100039

出　　处：《检验医学与临床》2014年第22期3107-3108,3111,共3页Laboratory Medicine and Clinic

摘　　要：目的：观察肝硬化合并革兰阳性（G＋）和阴性（G-）细菌感染患者血清降钙素原（PCT）水平变化特点。方法对2013年10月至2014年2月该院收治的61例肝硬化合并细菌感染患者（血培养阳性），按照细菌鉴定结果将患者分为肝硬化合并G＋细菌组（G＋组）和肝硬化合并G－细菌组（G－组）。分别采用电阻抗结合流式细胞术检测全血白细胞总数（WBC）、中性粒细胞绝对值（N）、中性粒细胞百分比（N％）；采用电化学发光法检测患者血清PCT水平，采用免疫比浊法测定C反应蛋白（CRP）水平。结果G＋组和G－组WBC、N、N％、PCT和CRP水平均高于正常参考范围。两组患者血清PCT水平比较，G－组明显高于G＋组，差异有统计学意义（P＜0．01）。WBC、N、N％、CRP水平在两组间比较，差异无统计学意义（P＞0．05）。在PCT＞2ng／mL和＞1～2ng／mL水平，G－组百分率明显高于G＋组（P＜0．01）。PCT在＞0．05～1ng／mL水平，G＋组百分率明显高于G－组（P＜0．01）。结论肝硬化合并G－组血清PCT水平高于G＋组。PCT检测有助于肝硬化合并细菌感染患者早期合理用药。Objective To investigate the change characteristics of serum procalcitonin（PCT ）level in the pa‐tients with liver cirrhosis complicating Gram positive（G＋ ）and Gram negative（G- ）bacterial infection .Methods 61 cases of liver cirrhosis complicating bacterial infection（positive blood culture）treated in our hospital from October 2013 to February 2014 were divided into the liver cirrhosis complicating G＋ bacteria group（G＋ group）and the liver cirrhosis complicating G- bacteria group（G- group）according to the bacterial identification results .The total white blood cell count（WBC） ,neutrophil absolute value（N）and neutrophil percentage（N% ）were tested by the electrical impedance and the flow cytometry methods .The PCT level was tested by the electrochemical luminescence method . And the C reactive protein（CRP）level was tested by the immunoturbidimetric assays .Results The WBC ,N ,N% , CRP and PCT levels in the G＋ and the G - group were higher than normal reference range .The difference of PCT levels between the G - group and the G＋ group was statistically significant ,and the PCT level in the G- group wase significantly higher than that in the G＋ group（P〈0 .01） .However WBC ,N ,N% and CRP had no statistically signif‐icant difference between the two groups（P〉0 .05） .In PCT 〉 2 and 〉1-2 ng/mL level ,the percentage of the G-group was significantly higher than that in the G＋ group（P〈0 .01） .PCT in 〉0 .05-1 ng/mL level ,the percentage of the G＋ group was significantly higher than that in the G- group（P〈0 .01） .Conclusion The serum PCT level in liver cirrhosis complicating G - bacterial infection is higher than that complicating G＋ bacterial infection .The PCT detection will contribute to the early rational use of antimicrobial agents in the patients with liver cirrhosis complica‐ting bacterial infection .

关 键 词：肝硬化 细菌感染 降钙素原 C反应蛋白 

分 类 号：R51[医药卫生—内科学]