革兰阳性细菌感染致脓毒症患者血清免疫炎性指标水平检测临床价值分析  

Clinical detection value of serum immune inflammatory indexes in patients with sepsis induced by Gram-positive bacteria infection

作　　者：张沙 ZHANG Sha(Department of Laboratory Medicine,Shan County Dongda Hospital,Shandong Heze 274300)

机构地区：[1]单县东大医院检验科,山东菏泽274300

出　　处：《医学检验与临床》2024年第2期33-37,共5页Medical Laboratory Science and Clinics

摘　　要：目的:分析革兰阳性细菌感染致脓毒症患者血清免疫炎性指标水平检测临床价值。方法:选取2020年12月-2022年12月在单县东大医院收治的72例革兰阳性细菌感染脓毒症患者作为研究组,另选取革兰阳性菌感染非脓毒症患者72例为对照组。采集患者外周静脉血检测患者血清降钙原素(Procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)、白介素(interleukin,IL)-6、IL-4、-千扰素(Interferon-,IFN),比较各组间差异。研究组患者根据治疗后30天(Day,d)的预后分为死亡组和存活组,比较死亡组和存活组患者血清指标,ROC分析影响近期预后的指标。结果:研究组血清PCT、CRP、IL-6水平均高于对照组,IFN-/IL-4比值低于对照组(P<0.05);经治疗后30d,研究组患者有15例患者死亡,死亡率为20.83%。死亡组年龄、入院APACHEⅡI评分和SOFA评分均大于存活组(P<0.05);经倾向匹配法进行匹配,共得到12对患者,死亡组PCT、IL-6水平均高于存活组,IFN-/IL-4比值低于存活组(P<0.05)。ROC曲线分析结果显示,血清PCT、IL-6水平和IFN-/IL-4比值均具有预测革兰阳性菌感染的脓毒症患者短期预后的价值(P<0.05)。结论:革兰阳性菌血流感染致脓毒症死亡患者炎症反应比存活患者更严重,且血清PCT、IL-6水平和IFN-/IL-4比值可能具有预测革兰阳性菌感染脓毒症患者短期预后的价值。Objective:To analyze the clinical detection value of serum immune inflammatory indexes in patients with sepsis induced by Gram-positive bacteria infection.Methods:A total of72 patients with sepsis induced by Gram-positive bacteria infection and 72 nonsepsis patients in the shan county dongda hospital were enrolled as study group and control group between December 2020 and December 2022,respectively.The peripheral venous blood was collected to detect serum procalcitonin(PCT),C-reactive protein(CRP),interleukin(IL)-6,IL-4 and-interferon(IFN-),and the differences in different groups were compared.According to prognosis at 30 d after treatment,patients in study group were divided into death group and survival group,and serum indexes in the two groups were compared.The influencing factors of short-term prognosis were analyzed by ROC curves.Results:The levels of serum PCT,CRP and IL-6 in study group were higher than those in control group,while IFN-/IL-4 ratio was lower than that in control group(P<0.05).At 30 d after treatment,there were 15 death cases in study group,with mortality rate of 20.83%.The age,APACHE II score at admission and SOFA score in death group were higher than those in survival group(P<0.05).According to propensity matching method,there were 12 pairs of patients.The levels of PCT and IL-6 in death group were higher than those in survival group,while IFN-/IL-4 ratio was lower than that in survival group(P<0.05).The results of ROC curves analysis showed that serum PCT,IL-6 and IFN-/IL-4 ratio were of predictive value for short-term prognosis of patients with sepsis induced by Gram-positive bacteria infection(P<0.05).Conclusion:In patients with sepsis induced by Gram-positive bacteria infection,inflammatory response in the died is more serious than that in the survived.The serum PCT,IL-6 and IFN-y/IL-4 ratio may be of predictive value for short-term prognosis.

关 键 词：革兰阳性细菌 脓毒症 免疫炎性指标 临床价值 

分 类 号：R459.7[医药卫生—急诊医学]