摘要
目的:分析恶性淋巴瘤患者经外周静脉置入中心静脉导管(PICC)导管相关性血流感染的病原菌分布,探究患者中性粒细胞淋巴细胞数比值(NLR)、D-二聚体等因子的表达及其意义。方法:选取我院收治的恶性淋巴瘤患者108例,按是否发生PICC导管相关性血流感染分为感染组28例和非感染组80例,对感染组样本进行病原体培养统计病原菌分布;比较两组患者NLR、D-二聚体、血栓调节蛋白(TM) 3项指标,通过受试者工作特征曲线(ROC曲线)评价3项指标对临床诊断的价值。结果:感染组细菌培养共检出病原菌32株,包括革兰阳性菌20株(其中金黄色葡萄球菌共14株)、革兰阴性菌11株(以肺炎克雷伯菌为主)及真菌1株。感染组患者NLR、D-二聚体和TM值均显著升高(P <0. 05); 3项血液因子的诊断效能均较高。结论:恶性淋巴瘤患者PICC导管相关性血流感染病原菌以革兰阳性菌为主,感染患者NLR、D-二聚体、TM均显著升高,3项指标均具有诊断价值,NLR升高表明患者存在全身细菌性炎症反应。
Objective： To analyze the etiological distribution of peripherally inserted central catheter（PICC）-related blood flow infection,and to explore the expression and significance of neutrophil-lymphocyte ratio（NLR）,D-Dimer and other factors in patients with malignant lymphoma. Methods： One hundred and eight cases of malignant lymphoma treated in our hospital were enrolled in this study. The patients were divided into infection group（n = 28） and non-infection group（n = 80）. The pathogenic bacteria were cultured and the distribution of pathogenic bacteria was analyzed in the infection group. The levels of NLR,D-Dimer and thrombomodulin（TM）were compared between the two groups. The diagnostic value of the three indexes was evaluated by ROC curve.Results： Thirty-two strains of pathogenic bacteria were detected in blood culture specimens,which included 20 strains of gram-positive bacteria（14 strains of Staphylococcus aureus）,11 strains of gram-negative bacteria（mainly Klebsiella pneumoniae） and 1 strain of fungus. The levels of NLR,D-Dimer and TM in the infection group were significantly elevated（P 〈 0. 05）,and the diagnostic efficiency of the three indicators was higher. Conclusion：Gram-positive bacteria are the main pathogenic bacteria in PICC-related blood flow infection in patients with malignant lymphoma. The levels of NLR,D-Two and TM are significantly increased in patients with infection,which plays an important role in the diagnosis. NLR elevation indicates that there is a bacterial inflammatory reaction of the whole body.
作者
曹琪
戚晓梅
CAO Qi;QI Xiaomei(Department of Oneology;Department of Hematology,Wuxi Second People＇s Hospital,Wuxi 214002,China)
出处
《现代医学》
2018年第10期1098-1102,共5页
Modern Medical Journal
基金
国家自然科学基金资助项目(81502365)
无锡市卫生计生委适宜技术项目(T201703)
