肺结核合并感染患者3项指标联合检测的临床应用  

Clinical application of combined detection of three indicators in pulmonary tuberculosis patients accompanied with infection

作　　者：刘梅春[1] 赵爱华[1] 尹石华[1] 

机构地区：[1]东营市胜利医院检验科,山东257055

出　　处：《国际检验医学杂志》2015年第3期350-351,354,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨肺结核合并细菌、真菌感染患者血浆内毒素、降钙素原(PCT)及(1,3)-β-D葡聚糖(BG)水平检测的临床意义。方法回顾性分析该院2013年3月至2013年12月结核病防治所收治的肺结核确诊病例240例临床资料,根据细菌培养结果将患者分为革兰阴性(G-)菌生长组39例、革兰阳性(G+)菌(包括真菌)生长组45例、无菌生长组156例,另选该院健康体检中心体检健康者48例纳入健康对照组。比较各组患者的血浆内毒素、PCT及BG水平变化。结果 G-菌生长组内毒素水平为(0.682±0.418)EU/mL、PCT水平为(2.93±0.87)μg/L,明显高于G+菌(包括真菌)生长组的(0.063±0.034)EU/mL及(0.85±0.52)μg/L,比较差异有统计学意义(P<0.05)。G-菌生长组内毒素、PCT水平明显高于无菌生长组(P<0.05)。健康对照组与无菌生长组内毒素、PCT、BG水平比较差异无统计学意义(P>0.05),而与其他组比较差异有统计学意义(P<0.05)。结论血浆内毒素、PCT及BG水平检测具有快速、敏感的特点,联合检测有助于快速判断肺结核患者是否合并G-菌、真菌感染,对指导临床合理用药、及时对症治疗具有重要意义。Objective To explore the clinical significance of the three indicators combined detection that plasma endotoxin,procalcitonin（PCT）and（1,3）-β-D-glucan（BG）in pulmonary tuberculosis patients complicated with bacterial,fungal infection.Methods Retrospective investigation was conducted in 240 pulmonary tuberculosis patients,who were divided into gram negative bacteria（G-）group（39cases）,gram positive bacteria（G＋）group（45cases）including fungal,germ-free group（156cases）.Other 45 healthy people were selected into control group.The levels of plasma endotoxin,PCT and BG in the four groups were compared.ResultsThe levels of plasma endotoxin（0.682±0.418）EU/mL,PCT（2.93±0.87）μg/L in the G-group were significant higher than those of the G＋group（0.063±0.034）EU/mL,（0.85±0.52）μg/L,the difference was significant（P〈0.05）.The levels of the plasma endotoxin,PCT in the G-group were higher than those of the germ-free group.The levels of plasma endotoxin,PCT and BG in the control group had no significant difference with those of the germ-free group.Conclusion The combined detection of plasma endotoxin,PCT and BG have some clinical value on the early diagnosis of the patients with pulmonary tuberculosis complicated with Gfungal infection for the advantages of fast and sensitiveness.

关 键 词：肺结核 内毒素 降钙素原 (1 3)-β-D葡聚糖 

分 类 号：R521[医药卫生—内科学]