重症肺炎患者病原菌分布与血清PCT、CRP、RAGE、sTREM-1变化分析  

Analysis of pathogenic distribution and change of serum PCT,CRP,RAGE,sTREM-1 in patients with severe pneumonia

作　　者：刘丁维 魏青政 邵圆愿[1] LIU Dingwei;WEI Qingzheng;SHAO Yuanyuan(Department of Clinical Laboratory, Qingdao Mumicipal Hospital, Qingdao, Shandong 266011, China)

机构地区：[1]青岛市市立医院检验科,山东青岛266011

出　　处：《国际检验医学杂志》2018年第19期2369-2372,共4页International Journal of Laboratory Medicine

基　　金：山东省医药卫生科研项目(2005-99)

摘　　要：目的分析重症肺炎患者病原菌分布与血清降钙素原(PCT)、C反应蛋白(CRP)、晚期糖化产物受体(RAGE)、可溶性髓样细胞触发受体-1(sTREM-1)变化。方法回顾性分析该院2014年2月至2017年5月收治的178例重症肺炎患者资料,按照28d内疾病转归情况分为存活组(n=113)和死亡组(n=65)。同期选择175例普通肺炎患者资料,165例健康者资料作为对照组。分析重症肺炎患者病原菌分布情况,比较各组血清PCT、CRP、RAGE、sTREM-1水平,并分析之间的联系。结果 178例重症肺炎患者中真菌为24.15%(43/178)、革兰阳性菌率为21.34%(38/178)、革兰阴性菌率为54.49%(97/178)。重症肺炎组革兰阴性菌阳性率高于普通肺炎组,血清PCT、CRP、RAGE、sTREM-1依次高于普通肺炎组及对照组,差异有统计学意义(P<0.05)。死亡组革兰阴性菌阳性率高于存活组,血清PCT、CRP、RAGE、sTREM-1明显高于存活组,差异有统计学意义(P<0.05)。重症肺炎患者血清PCT、CRP、RAGE、sTREM-1之间均呈正相关(P<0.05)。结论重症肺炎患者病原菌分布以革兰阴性菌为主,观察血清PCT、CRP、RAGE、sTREM-1水平能够利于疾病鉴别,评估其进展程度。Objective To analyze the distribution of pathogenic bacteria and the changes of serum procalcitonin （PCT） ,c-reactive protein （CRP）,advanced glycation product receptor （RAGE） and soluble myeloid cell trigger tor-l （sTREM-1） in patients with severe pneumonia. Methods The data of 178 patients with severe pneumonia recep- ted to our hospital from February 2014 to may 2017 were retrospectively analyzed. They were divided into survival group （n=113） and death group （n=65） according to the outcome of the disease within 28 days. At the same time, 175 patients with common pneumonia were selected,and 165 healthy persons were selected as control group. The dis- tribution of pathogenic bacteria in patients with severe pneumonia was analyzed. The levels of serum PCT, CRP, RAGE,sTREM-1 in each group were compared and the relationship between them was analyzed. Results Among 178 patients with severe pneumonia, fungi were 24. 15 % （43/178 ）, gram gram-negative bacteria were 54.49% （97/178）. The positive bacteria were 21.34% （38/178） and positive rate of gram-negative bacteria in the severe pneumonia group was higher than that in the common pneumonia group,and the serum PCT, CRP, RAGE, sTREM-1 were higher than those in the common group and the control group, the difference was statistically significant （P〈0.05）. The positive rate of gram-negative bacteria in the death group was higher than that in the survival group,while serum PCT,CRP,RAGE, sTREM-1 were significantly higher than those in the survival group （P〈0. 05）. Serum PCT,CRP,RAGE,sTREM-1 in patients with severe pneumonia were positively correlated （P〈0.05）. Conclusion The distribution of pathogenic bacteria in patients with severe pneumonia is mainly gram-negative bacteria and obser- vation of serum PCT,CRP,RAGE and sTREM-1 levels can be helpful to identify the disease and assess its progress.

关 键 词：重症肺炎 降钙素原 C反应蛋白 晚期糖化终产物受体 可溶性髓样细胞触发受体-1 

分 类 号：R563.1[医药卫生—呼吸系统]