血清1,3-β-D葡聚糖在极低出生体质量儿真菌败血症中的临床分析  

Clinical Analysis of Serium 1,3-β-D Glucan in Fungal Sepsis of Very Low Birth Weight Infants

作　　者：肖万祥[1] 蔡协君 邹彩艳[1] 杨婷[1] 熊欣 袁毅 XIAO Wanxiang;CAI Xiejun;ZOU Caiyan;YANG Ting;XIONG Xin;YUAN Yi(Department of Neonatal,Jinan University-affiliated Shenzhen Baoan Women’s and Children’s Hospital,Shenzhen Guangdong 518102,China;Department of Neonatal,University of Chinese Academy of Science-affiliated Shenzhen Hospital,Shenzhen Guangdong 518000,China)

机构地区：[1]暨南大学附属深圳市宝安妇幼保健院新生儿科,广东深圳518102 [2]中国科学院大学附属深圳医院新生儿科,广东深圳518000

出　　处：《中国继续医学教育》2021年第10期117-121,共5页China Continuing Medical Education

基　　金：广东省深圳市宝安区科技创新局医疗卫生基础研究项目(2019JD352)。

摘　　要：目的探讨血清1,3-β-D葡聚糖检测在极低出生体质量儿侵袭性真菌性败血症中的诊断和预后作用。方法选择2017年9月-2019年9月疑似侵袭性真菌败血症患儿共78例,分为治疗组(确诊侵袭性真菌败血症)和对照组(非侵袭性真菌败血症)。比较两组血清1,3-β-D葡聚糖、白细胞、血小板、超敏C反应蛋白(CRP)差异;同时比较治疗组在治疗后第7天、第14天与治疗前清血清1,3-β-D葡聚糖、白细胞、血小板、超敏C反应蛋白(CRP)的变化。结果治疗组血清1,3-β-D葡聚糖、超敏CRP水平显著高于对照组,血小板显著低于对照组,差异均有统计学意义(P <0.05)。治疗组血清1,3-β-D葡聚糖、超敏CRP在治疗后第7天和第14天较治疗前有明显降低,差异均有统计学意义(P <0.05)。血小板在治疗后第7天与治疗前比仍继续下降,但治疗后第14天明显高于治疗前。白细胞在治疗组和对照组,治疗前后均无差别(P> 0.05)。结论血清1,3-β-D葡聚糖,结合血小板及超敏CRP的变化,为临床极低出生体质量儿侵袭性真菌感染的诊断及治疗提供重要的参考价值。Objective To explore the diagnosis and prognosis of serum 1,3-β-D glucan in invasive fungal sepsis in very low birth weight infants.Methods Seventy-eight very low birth weight infants suspected of invasive fungal infection were selected from September 2017 to September 2019,blood culture was performed.The infants with positive blood culture result were designed as treatment group,while the infants with negative blood culture result were designed as control group.The level of serum 1,3-β-D glucan,white blood cell,platelet counts and hyper-sensitive C-reactive protein were detected,and in the two groups they were compared.To the treatment group,the level of serum 1,3-β-D glucan,white blood cell,platelet counts and hyper-sensitive C-reactive protein were compared on day 7 and 14 after treatment with that before treatment.Results The levels of serum 1,3-β-D glucan and hyper-sensitive C-reactive protein in patients of treatment group were significantly higher than those in control group,and platelet counts was significantly lower than that in control group(P<0.05).The levels of serum 1,3-β-D glucan and hyper-sensitive C-reactive protein were significantly lower on days 7 and 14 than those before treatment in the treatment group(P<0.05);after treatment the platelet counts continued to decrease on day 7 compared with that before treatment,but it was significantly higher on day14 compared with that before treatment.White blood cell has no difference between the treatment group and the control group(P>0.05).Conclusion The levels of serum 1,3-β-D glucan,combined with changes in platelet counts and hyper-sensitive C-reactive protein,provide important reference value for the diagnosis and treatment of invasive fungal infections in very low birth weight infants.

关 键 词：1 3-β-D葡聚糖 侵袭性真菌 败血症 极低出生体质量儿 诊断 预后 

分 类 号：R722[医药卫生—儿科]