198例脓毒血症患者心功能评估及细菌耐药性分析  

Evaluation of cardiac function and analysis of bacterial resistance in 198 patients with sepsis

作　　者：邸师红 代超 祝茜 苏春霞[2] DI Shi-hong;DAI Chao;ZHU Qian;SU Chun-xia(Department of Cardiology and Cerebrovascular Disease,General Hospital of Ningxia Medical University,Yinchuan,Ningxia 150000,China;不详)

机构地区：[1]宁夏医科大学总医院心脑血管病医院医学检验科,宁夏银川750000 [2]宁夏医科大学基础医学院病原生物学与免疫学系,宁夏银川750004

出　　处：《中国卫生检验杂志》2021年第11期1384-1388,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的分析医院重症监护室(ICU)脓毒血症患者心功能指标和细菌耐药性。方法选取ICU普通脓毒血症组112例、重度脓毒血症合并休克组86例、菌血症组100例和健康对照组100例,进行心功能评估及细菌耐药性分析。结果脓毒血症组患者心率、急性生理和慢性健康状况评分、左室舒末内径、左房内径、肌钙蛋白、肌酸激酶同工酶、N端脑钠肽前体(NT-proBNP)等心肌损伤指标水平高于菌血症组与健康对照组,左室射血分数、短轴缩短率水平低于菌血症组与对照组,差异均有统计学意义(P<0.05);210株病原菌中,革兰阳性菌占37.1%,革兰阴性菌占56.7%,耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌分别为31.2%和68.0%,耐碳青霉烯的铜绿假单胞菌和鲍曼不动杆菌分别为23.9%和85.8%。结论超声心动图联合NT-proBNP等指标可较好地评估患者心功能和病情严重程度。细菌耐药率较高,应加强院感防控,降低患者病死率。Objective To explore the characteristics of cardiac function and bacterial resistance in patients with sepsis in intensive care unit(ICU).Methods Cardiac function assessment and bacterial resistance analysis were performed on the normal sepsis group(112 cases)from ICU,severe sepsis combined with shock group(86 cases),bacteremia group(100 cases)and the control group(100 cases).Results The heart rate,the scores of APACHEⅡ,LVEDD,LAD,cTnI,CKMB,NT-proBNP in sepsis group were higher than those in bacteremia group and the control group,while the LVEF and FS levels were lower,with the differences statistically significant(P<0.05).37.1%were gram-positive bacteria and 56.7%were gram-negative bacteria in 210 strains of pathogenic bacteria of which MRSA and MRCNS were 31.2%and 68.0%,respectively,and the carbapenem resistant Pseudomonas aeruginosa and Acinetobacter baumannii were 23.9%and 85.8%,respectively.Conclusion Echocardiography combined with NT-proBNP and other indicators can better evaluate the cardiac function and severity of the disease.Bacterial resistance rate is high,so it is necessary to strengthen the prevention and control of nosocomial infection and reduce the mortality of patients.

关 键 词：重症监护病房 脓毒血症 心功能受损 耐药率 

分 类 号：R631.2[医药卫生—外科学]