血液病患者血流感染的病原学分析及血清淀粉样蛋白A、人中性粒细胞脂蛋白及内毒素的检测价值  

Etiology analysis of bloodstream infection in patients with hematological diseases and detection value of serum amyloid A,human neutrophil lipoprotein and endotoxin

作　　者：赵昕 ZHAO Xin(Department of Infection Control,the Second Hospital,University of South China,Hunan Province,Hengyang421001,China)

机构地区：[1]南华大学附属第二医院感控部,湖南衡阳421001

出　　处：《中国当代医药》2023年第14期65-67,88,共4页China Modern Medicine

摘　　要：目的分析血液病患者血流感染的病原学及血清淀粉样蛋白A(SAA)、人中性粒细胞脂蛋白(HNL)及内毒素的检测价值。方法选取2021年1月至2022年2月于南华大学附属第二医院就诊的66例血液病患者作为研究对象,按照血流是否感染其分为感染组(n=35)和非感染组(n=31),所有患者均进行血清SAA、HNL及内毒素检测,比较两组患者体内SAA、HNL及内毒素水平变化,统计分析血流感染阳性患者的病原学分布,采用Pearson相关性评估血清SAA、HNL及内毒素与APACHEⅡ评分的关系,并采用ROC曲线评价各项指标诊断血流感染效能。结果血液感染组患者的血清SAA、HNL及内毒素水平均高于血液非感染组,差异有统计学意义(P<0.05),血流感染的主要病原菌类型是革兰氏阴性菌和革兰氏阳性菌,其中革兰氏阴性菌中以肺炎克雷伯菌和铜绿假单胞菌为主,占比均为革兰氏阴性菌的26.32%,革兰氏阳性菌中以金黄色葡萄球菌为主,占比为革兰氏阳性菌的36.36%。由ROC曲线得知,血清SAA的AUC为0.993,HNL的AUC为0.907,内毒素的AUC为0.967。结论血液病患者血清SAA、HNL及内毒素水平对诊断血流感染具有较高的检测价值,可为临床早期治疗和预后评估提供数据支持。Objective To explore the etiology of bloodstream infection in patients with hematological diseases and the detection value of levels of serum amyloid A(SAA),human neutrophil lipoprotein(HNL)and endotoxin.Methods Sixty-six patients with hematological diseases treated in the Second Affiliated Hospital,University of South China from January 2021 to February 2022 were selected as the study subjects and were divided into infection group(n=35)and non-infection group(n=31)according to whether the blood stream was infected or not.The levels of serum SAA,HNL and endotoxin were detected among all the patients,and the changes of above levels were compared between the two groups.The pathogen distribution in patients with bloodstream infection was statistically analyzed.Pearson correlation was used to analyze the relationship between serum SAA,HNL,endotoxin and APACHEⅡscore,and ROC curve was applied to evaluate the efficiency of each indicator in the diagnosis of bloodstream infection.Results The levels of SAA,HNL and endotoxin in bloodstream infection group were higher than those in bloodstream non-infection group,the differences were statistically significant(P<0.05).The main pathogenic bacteria of bloodstream infection were Gram-negative bacteria and Gram-positive bacteria,and Gram-negative bacteria were mainly Klebsiella pneumoniae(26.32%)and Pseudomonas aeruginosa(26.32%)and Gram-positive bacteria were mainly Staphylococcus aureus(36.36%).According to the ROC curve,the AUC was 0.993 of serum SAA,the AUC was 0.907 of HNL,and the AUC was 0.967 of endotoxin,respectively.Conclusion Serum levels of SAA,HNL and endotoxin in patients with hematological diseases have high detection value on bloodstream infection,and they can provide data support for early clinical treatment and prognosis evaluation.

关 键 词：淀粉样蛋白A 人中性粒细胞脂蛋白 内毒素 血流感染 血液病 

分 类 号：R559[医药卫生—血液循环系统疾病]