血清CRP和IL-8联合TNF-α诊断患儿植入式静脉输液港相关血流感染的价值  

Value of serum CRP and IL-8 combined with TNF-αin diagnosis of implantable venous port-associated bloodstream infection in children

作　　者：秦爱华[1] 刘东英[2] 白桦[3] 董红艳[1] 马翠玲[4] QIN Ai-hua;LIU Dong ying;BAI Hua;DONG Hongyan;MA Cui-ling(Shangqiu Medical College Nursing College,Shangqiu,Henan 476000.China;不详)

机构地区：[1]商丘医学高等专科学校护理学院,河南商丘476000 [2]河南省肿瘤医院护理部,河南郑州450052 [3]郑州大学第三附属医院护理部,河南郑州450052 [4]商丘市第一人民医院急诊科,河南商丘476100

出　　处：《中华医院感染学杂志》2020年第14期2206-2210,共5页Chinese Journal of Nosocomiology

基　　金：河南省高等教育教学改革研究与实践基金资助项目(2017SJGLX174)。

摘　　要：目的探讨血清C-反应蛋白(CRP)、白细胞介素-8(Interleukin-8,IL-8)和肿瘤坏死因子-α(TNF-α)预测儿童IVAP导致相关血流感染的诊断价值。方法选取2017年1月-2019年7月商丘医学高等专科学校附属医院就诊的450例患儿,将53例植入式静脉输液港感染患儿设置为研究组,其余397例未感染患儿设置为对照组。采用免疫比浊法检测CRP,采用酶联免疫法检测IL-8、TNF-α,对三种单一方法检测和联合检测相关血流感染的检出率进行比较。结果血流感染的患儿中革兰阳性菌是主要致病菌;多因素分析结果显示,置管时间过长、使用刺激性药物、固定材料尺寸、低蛋白血症是引起IVAP术后患儿发生相关血流感染的独立危险因素(P<0.05);研究组的血清CRP、IL-8和TNF-α水平均高于对照组的水平,差异具有统计学意义(P<0.05);受试者工作特征曲线(ROC)分析结果显示,CRP、IL-8、TNF-α及联合对IVAP术后患儿发生相关血流感染诊断曲线下面积分别为0.752、0.776、0.802、0.894均具有统计学意义(P<0.05)。结论血清CRP、IL-8联合TNF-α在预测患儿植入式静脉输液港导致相关血流感染方面有较高的诊断价值,值得临床应用。OBJECTIVE To explore the value of serum C-reactive protein(CRP)and nterleukin-8(IL-8)combined with tumernecrosis factor-α(TNF-α)in diagnosis of IVAP-associated bloodstream infection in the children.METHODS A total of 450 children who were treated in Shangqiu Medical College Affiliated Hospital from Jan 2017 to Jul 2019 were enrolled in the study,53 children who had IVAP-associated bloodstream infection were assigned as the study group,and 397 children without infection were set as the control group.The CRP was detected by using immunoturbidimetry,the levels of IL-8 and TNF-αwere detected by means of ELISA,and the detection rates were observed and compared among the single detection of index and the joint detection of the three indexes.RESULTS The gram-positive bacteria were dominant among the pathogens causing the bloodstream infection in the children.The result of multivariate analysis showed that the long catheter indwelling time,use of irritant drugs,size of fixed material and hypoproteinemia were the independent risk factors for the postoperative bloodstream infection in the IVAP children(P<0.05).The levels of serum CRP,IL-8 and TNF-αof the study group were significantly higher than those of the control group(P<0.05).The result of ROC curve analysis indicated that the areas under curve of CRP,IL-8,TNF-αand the joint detection of the three indexes were respectively 0.752,0.776,0.802 and 0.894(P<0.05).CONCLUSION The joint detection of serum CRP,IL-8 and TNF-αhad high value in diagnosis of the IVAP-associated bloodstream infection,and it is worthy to be promoted in the hospital.

关 键 词：儿童 植入式静脉输液港 相关血流感染 C-反应蛋白 白细胞介素-8 肿瘤坏死因子-Α 联合检测 诊断价值 

分 类 号：R473.72[医药卫生—护理学]