NLR、PCT联合铁蛋白检测在阑尾炎伴局限性腹膜炎患者术后腹腔感染中的预测价值及病原菌分析  

Predictive value of NLR,PCT and ferritin detection in postoperative abdominal infection in patients with appendicitis and localized peritonitis and analysis of pathogenic bacteria

作　　者：徐桐 杨栋民 齐贺斌 徐楠 刘姗姗 XU Tong;YANG Dongmin;QI Hebin;XU Nan;LIU Shanshan(Department of Clinical Laboratory,Qinhuangdao Workers'Hospital,Qinhuangdao,Hebei,China,066200;Department of Medical Cosmetics,the First Hodpital of Qinhuangdao,Qinhuangdao,Hebei,China,066200;Department of Neurology,the First Hodpital of Qinhuangdao,Qinhuangdao,Hebei,China,066200;Department of General Surgery,Qinhuangdao Workers'Hospital,Qinhuangdao,Hebei,China,066200)

机构地区：[1]秦皇岛市工人医院检验科,河北秦皇岛066200 [2]秦皇岛市第一医院医学美容科,河北秦皇岛066000 [3]秦皇岛市第一医院神经内科,河北秦皇岛066000 [4]秦皇岛市工人医院普外科,河北秦皇岛066200

出　　处：《分子诊断与治疗杂志》2025年第1期71-74,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省卫生健康委员会重点科技研究计划项目(20221611);秦皇岛市科学技术研究与计划发展项目(202101A194)。

摘　　要：目的探究中性粒细胞/淋巴细胞比值(NLR)、降钙素原(PCT)联合铁蛋白(Fer)在阑尾炎伴局限性腹膜炎患者术后腹腔感染中的预测价值,并分析术后腹腔感染的病原菌分布情况。方法选取2023年4月至2024年5月期间秦皇岛市工人医院收治的阑尾炎伴局限性腹膜炎121例。统计患者术后继发腹腔感染情况;分析感染组病原菌分布情况以及构成比;比较感染组与非感染组的一般资料及NLR、PCT、Fer水平;采用logistic多因素分析阑尾炎伴局限性腹膜炎患者出现腹腔感染的相关因素;分析NLR、PCT、Fer单独及联合检测对阑尾炎伴局限性腹膜炎合并腹腔感染的预测效果。结果121例患者中,术后继发腹腔感染者34例(感染组),未发生感染者87例(无感染组);两组性别、年龄、BMI比较,差异无统计学意义(P>0.05);感染组NLR、PCT、Fer水平显著高于未感染组,差异有统计学意义(P<0.05);经过培养,感染组共分离出56株病原菌,其中革兰氏阳性菌中肠球菌7株(12.50%)、链球菌6株(10.71%),革兰氏阴性菌中大肠埃希菌23株(41.07%)、铜绿假单胞菌9株(16.07%)、肺炎克雷伯菌8株(14.29%)、阴沟肠杆菌3株(5.36%)。logistic多因素分析显示,NLR>4.40、PCT>7.00 ng/mL、Fer>1.20 ng/mL均是影响阑尾炎伴局限性腹膜炎患者出现腹腔感染的独立危险因素(P<0.05);NLR、PCT、Fer三者联合诊断阑尾炎伴局限性腹膜炎合并腹腔感染的AUC为0.812,高于三指标单独检测(P<0.05)。结论NLR、PCT、Fer在阑尾炎伴局限性腹膜炎合并腹腔感染患者中表达异常,三指标联合检测可提高阑尾炎伴局限性腹膜炎合并腹腔感染的诊断效能,可为临床治疗提供可靠依据。Objective To explore the predictive value of neutrophil/lymphocyte ratio(NLR),procalcitonin(PCT)combined with ferritin(Fer)in postoperative abdominal infection in patients with appendicitis and localized peritonitis,and to analyze the distribution of pathogenic bacteria in postoperative abdominal infection.Methods A total of 121 cases of appendicitis with localized peritonitis admitted to Qinhuangdao Workers'Hospital from April 2023 to May 2024 were selected.The study analyzed statistics of patients with postoperative secondary abdominal infection,as well as the distribution and composition ratio of pathogenic bacteria in the infection group.General,NLR,PCT,and Fer levels were compared between the infected group and the non⁃infected group.Logistic multivariate analysis was used to analyze the related factors of abdominal infection in patients with appendicitis and localized peritonitis.The study also calculated the predictive effects of NLR,PCT,and Fer alone and in parallel on appendicitis with localized peritonitis complicated with abdominal infection.Results Of the 121 patients,34 had postoperative abdominal infections(infection group)and 87 had no infections(non⁃infection group).There were no significant differences in gender,age,and BMI between the two groups(P>0.05).The levels of NLR,PCT,and Fer in the infected group were significantly higher than those in the uninfected group,and the differences were statistically significant(P<0.05).After culturing,56 strains of pathogenic bacteria were isolated from the infection group,including 7 strains of Enterococcus(12.50%)and 6 strains of Streptococcus(10.71%)in Gram⁃positive bacteria,23 strains of Escherichia coli(41.07%),9 strains of Pseudomonas aeruginosa(16.07%),8 strains of Klebsiella pneumoniae(14.29%)and 3 strains of Enterobacter cloacae(5.36%)in Gram⁃negative bacteria.Logistic multivariate analysis showed that NLR>4.40,PCT>7.00 ng/mL and Fer>1.20 ng/mL were independent risk factors for abdominal infection in patients with appendicitis and localized p

关 键 词：NLR PCT 铁蛋白 阑尾炎 局限性腹膜炎 腹腔感染 病原菌 

分 类 号：R656.8[医药卫生—外科学]