中性粒细胞碱性磷酸酶对骨科患者感染的诊断研究  

Value of neutrophils alkaline phosphatase in diagnosis of infections in patients of orthopedics department

作　　者：范国明[1] 贾少华[1] 周红梅[2] 张中伟[1] 沈杰[1] 

机构地区：[1]浙江省嘉兴市第二医院骨科,浙江嘉兴314000 [2]浙江省嘉兴市第二医院麻醉科,浙江嘉兴314000

出　　处：《中华医院感染学杂志》2017年第14期3244-3247,共4页Chinese Journal of Nosocomiology

基　　金：浙江省嘉兴市科技局基金资助项目(2014AY21031)

摘　　要：目的探讨中性粒细胞碱性磷酸酶(NAP)在骨科患者感染中的诊断价值。方法选取2011年1月-2016年3月医院骨科进行I类手术的患者6253例,发生感染患者为感染组,在未发生感染的患者中随机选取300例作为非感染组,术后1d,抽取外周静脉血,检测降钙素原(PCT),C-反应蛋白(CRP)和NAP,对感染患者进行病原菌检测。结果 6253例患者中共282例发生医院感染,医院感染率为4.5%;感染组NAP阳性率、NAP积分、CRP和PCT均显著高于非感染组,差异有统计学意义(P<0.05);282例感染患者共检出病原菌282株,其中革兰阳性菌126株,占44.68%,革兰阴性菌120株,占42.55%,支原体14株,占4.96%,病毒12株,占4.26%,其他菌株10株,占3.55%;革兰阴性菌感染患者NAP阳性率(99.53±0.15)和积分(452.36±65.28)均显著高于革兰阳性菌感染患者的(86.33±5.17)和(292.15±46.37),两组数据比较差异有统计学意义(P<0.05),而革兰阴性菌和革兰阳性菌感染患者CRP和PCT相比,差异无统计学意义;革兰阳性菌感染患者CRP(246.18±50.52)mg/L和PCT(1.25±0.26)ug/L显著高于支原体感染患者的(135.35±35.15)mg/L和PCT(1.01±0.33)ug/L,两组数据比较差异有统计学意义(P<0.05),而革兰阳性菌和支原体感染患者NAP阳性率和积分相比,差异无统计学意义。结论 NAP活性检测在骨科患者感染诊断方面具有重要临床价值,对于快速诊断和疗效判断具有重要意义。OBJECTIVE To explore the value of neutrophils alkaline phosphatase（NAP）in diagnosis of infections in patients of orthopedics department.METHODS A total of 6253 patients who received type I surgery in the department of orthopedics from JAN 2011 to Mar 2016 were enrolled in the study,the patients with infection were assigned as the infection group,and 300 patients without infections were randomly chosen as the non-infection group.The peripheral venous blood was drawn one day after the surgery so as to detect procalcitonin（PCT）,Creactive protein（CRP）,and NAP;the pathogens isolated from the patients with infections were identified.RESULTS Of the 6253 patients,282had the nosocomial infections,with the incidence of nosocomial infections 4.5%.The positive rate of NAP,NAP score,CRP level,and PCT level were significantly higher in the infection group than in the non-infection group（P〈0.05）.Totally 282 strains of pathogens were isolated from the 282 patients with infections,including 126（44.68%）strains of gram-positive bacteria,120（42.55%）strains of gramnegative bacteria,14（4.96%）strains of Mycoplasma,12（4.26%）strains of viruses,and 10（3.55%）strains of other species.The positive rate of NAP of the patients with gram-negative bacteria infections was（99.53±0.15）,significantly higher than（86.33±5.17）of the patients with gram-positive bacteria infection;the NAP score of the patients with gram-negative bacteria infection was（452.36±65.28）,significantly higher than（292.15±46.37）of the patients with gram-positive bacteria infection（P〈0.05）.There was no significant difference in the CRP or PCT levels between the patients with gram-negative bacteria infection and the patients with gram-positive bacteria infections.The CRP and PCT levels of the patients with gram-positive bacteria infection were respectively（246.18±50.52）mg/L and（1.25±0.26）ug/L,significantly higher than（135.35±35.15）mg/L and（1.01±0.33）ug/L of the patients with Mycoplasmainfections,�

关 键 词：中性粒细胞碱性磷酸酶 骨科 感染 

分 类 号：R687.3[医药卫生—骨科学]