大肠埃希菌和金黄色葡萄球菌血流感染脓毒症患者血清肾损伤分子-1和中性粒细胞明胶酶相关脂质运载蛋白及白细胞介素-6表达及意义  

Expressions and significances of serum kidney injury molecule-1,neutrophil gelatinase associated lipocalin and interleukin-6 in septic patients with bloodstream infection caused by Escherichia coli and Staphylococcus aureus

作　　者：赵飞 钱明月 周城伟 雷春梅 ZHAO Fei;QIAN Mingyue;ZHOU Chengwei;LEI Chunmei(Department of Laboratory,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Cardiovascular Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Emergency,the First Af filiated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Microbiology,the First Af filiated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院检验科,河北张家口075000 [2]河北北方学院附属第一医院心血管内科,河北张家口075000 [3]河北北方学院附属第一医院急诊科,河北张家口075000 [4]河北北方学院附属第一医院微生物科,河北张家口075000

出　　处：《中华实用诊断与治疗杂志》2025年第2期123-129,共7页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河北省医学科学研究课题计划(20240279)。

摘　　要：目的 观察大肠埃希菌和金黄色葡萄球菌血流感染脓毒症患者血清肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、白细胞介素-6(IL-6)水平,探讨三者在脓毒症血流感染诊断及预后预测中的价值。方法 2020年6月—2023年6月河北北方学院附属第一医院诊治脓毒症患者215例,均于诊断脓毒症24 h内完成血培养,采用ELISA法检测血清KIM-1、NGAL、IL-6水平。根据血培养结果分为血流感染组137例和非血流感染组78例,根据病原菌类型将血流感染组分为金黄色葡萄球菌组62例和大肠埃希菌组75例,分别比较各组血清KIM-1、NGAL、IL-6水平。观察血流感染组患者入院第28天时生存情况,其中金黄色葡萄球菌组生存34例、死亡28例,大肠埃希菌组生存29例、死亡46例,比较2组生存者与死亡者血清KIM-1、NGAL、IL-6水平。绘制ROC曲线,评估血清KIM-1、NGAL、IL-6诊断脓毒症患者血流感染、大肠埃希菌血流感染及预测大肠埃希菌血流感染脓毒症患者预后的效能。结果 血流感染组血清KIM-1、NGAL、IL-6水平[(82.03±14.58)ng/L、(448.23±85.51)μg/L、(208.93±40.36)μg/L]均高于非血流感染组[(59.95±8.99)ng/L、(305.10±68.61)μg/L、(161.39±20.93)μg/L](t=12.913、12.013、9.108,P均<0.001);大肠埃希菌组血清KIM-1、NGAL、IL-6水平[(90.29±10.97)ng/L、(490.18±73.72)μg/L、(229.99±29.99)μg/L]均高于金黄色葡萄球菌组[(72.04±11.96)ng/L、(397.48±70.19)μg/L、(191.53±39.67)μg/L](t=9.304、7.486、6.457,P均<0.001);大肠埃希菌组死亡者血清KIM-1、NGAL、IL-6水平[(97.19±9.45)ng/L、(534.22±54.47)μg/L、(217.85±38.23)μg/L]均高于生存者[(85.96±9.60)ng/L、(462.42±71.09)μg/L、(174.94±30.83)μg/L](t=4.981、4.933、5.087,P均<0.001),金黄色葡萄球菌组死亡者血清KIM-1、NGAL、IL-6水平[(74.23±12.58)ng/L、(404.29±81.62)μg/L、(196.50±45.14)μg/L]与生存者[(70.24±11.43)ng/L、(391.87±69.51)μg/L、(187.44±38.42)μg/L]�Objective To observe the serum levels of kidney injury molecule-1(KIM-1),neutrophil gelatinase associated lipocalin(NGAL)and interleukin-6(IL-6)in septic patients with bloodstream infection caused by Escherichia coli(EC)and Staphylococcus aureus(SA),and to investigate the value of them three to the diagnosis and prognosis prediction of bloodstream infection in septic patients.Methods Totally 215 septic patients were diagnosed and treated in the First Affiliated Hospital of Hebei North University from June 2020 to June 2023.Blood culture was completed within 24 h after diagnosis of sepsis.The serum levels of KIM-1,NGAL and IL-6 were detected with ELISA.All patients were divided into the bloodstream infection group(n=137)and the non-bloodstream infection group(n=78)according to the blood culture results,and the bloodstream infection group were redivided into the SA group(n=62)and the EC group(n=75).The serum levels of KIM-1,NGAL and IL-6 were compared.The 28-d survival was observed in the bloodstream infection group,of which 34 patients survived and 28 died in the SA group,and 29 patients survived and 46 died in the EC group.The serum levels of KIM-1,NGAL and IL-6 were compared between the surviving patients and dead patients in two groups.ROC curves were plotted to evaluate the efficiencies of serum KIM-1,NGAL and IL-6 on diagnosing bloodstream infection and EC bloodstream infection in septic patients and on predicting prognosis of septic patients with EC bloodstream infection.Results The serum levels of KIM-1,NGAL and IL-6 were higher in the bloodstream infection group[(82.03±14.58)ng/L,(448.23±85.51)μg/L,(208.93±40.36)μg/L] than those in the non-bloodstream infection group[(59.95±8.99)ng/L,(305.10±68.61)μg/L,(161.39±20.93)μg/L](t=12.913,12.013,9.108;all P values<0.001),were higher in the EC group[(90.29±10.97)ng/L,(490.18±73.72)μg/L,(229.99±29.99)μg/L]than those in the SAgroup[(72.04±11.96)ng/L,(397.48±70.19)μg/L,(191.53±39.67)μg/L](t=9.304,7.486,6.457;all P values<0.001),were higher in the d

关 键 词：脓毒症 血流感染 大肠埃希菌 金黄色葡萄球菌 肾损伤分子-1 中性粒细胞明胶酶相关脂质运载蛋白 白细胞介素-6 

分 类 号：R69[医药卫生—泌尿科学]