摘要
目的探讨金黄色葡萄球菌血流感染患儿的近期预后影响因素及中性粒细胞膜碱性磷酸酶(mNAP)、可溶性白细胞分化抗原14亚型(Presepsin)、髓样细胞触发受体-1(TREM-1)的预后预测价值。方法收集2018年1月—2019年12月金黄色葡萄球菌血流感染106例作为感染组,根据患儿治疗30 d的生存情况,将其分为死亡组(n=11)、生存组(n=95)。将同期接受体检的健康儿童100例作为正常对照组。对比感染组与正常对照组血清mNAP、Presepsin、TREM-1水平,以及不同预后金黄色葡萄球菌血流感染患儿临床资料的差异,同时分析影响金黄色葡萄球菌血流感染患儿近期预后的独立危险因素及血清mNAP、Presepsin、TREM-1对预后的预测价值。结果感染组血清mNAP、Presepsin、TREM-1水平高于正常对照组(P<0.05)。死亡组与生存组白细胞、淋巴细胞、C反应蛋白(CRP)、降钙素原(PCT)、mNAP、Presepsin、TREM-1水平及急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分比较差异有统计学意义(P<0.01)。白细胞、淋巴细胞、APACHEⅡ评分、CRP、PCT、mNAP、Presepsin、TREM-1水平较高均是影响金黄色葡萄球菌血流感染患儿近期死亡的独立危险因素(P<0.05)。血清mNAP、Presepsin、TREM-1预测金黄色葡萄球菌血流感染患儿近期死亡的曲线下面积分别为0.822、0.744、0.794。结论mNAP、Presepsin、TREM-1水平较高是影响金黄色葡萄球菌血流感染患儿近期死亡的独立危险因素,三者对患儿近期死亡具有早期预测价值。
Objective To investigate influencing factors of short-term prognosis in children with staphylococcus aureus bloodstream(SAB)infection and predictive values of membrane neutrophil alkaline phosphatase(mNAP),soluble leukocyte differentiation antigen 14 subtype(Presepsin)and trigger receptor expressed on myeloid cell-1(TREM-1).Methods A total of 106 patients with SAB infection between January 2018 and December 2019 were selected as infection group,and they were further divided into death subgroup(n=11)and survival subgroup(n=95)according to mortality of the children after treatment for 30 d.A total of 100 healthy children who had undergone physical examination at the same period were chosen as normal control group.Levels of serum mNAP,Presepsin and TREM-1 were compared between infection group and normal control group,and the differences in clinical data of SAB infection children with different prognoses were also compared.Independent risk factors affecting short-term prognoses of children with SAB infection and values of serum mNAP,Presepsin and TREM-1 in prediction of prognoses were analyzed.Results Levels of serum mNAP,Presepsin and TREM-1 in infection group were significantly higher than those in normal control group(P<0.05).Differences in levels of leukocyte,lymphocyte,C-reactive protein(CRP),procalcitonin(PCT),mNAP,Presepsin and TREM-1 and acute physiology and chronic health evaluation II(APACHE II)score were statistically significant between death and survival subgroups(P<0.01).High levels of leukocyte,lymphocyte,APACHE Ⅱ score,CRP,PCT,mNAP,Presepsin,and TREM-1 were independent risk factors affecting short-term mortality of children with SAB infection(P<0.05).Areas under the receiver operating curve(ROC)curve of serum mNAP,Presepsin and TREM-1 in predicting short-term mortality of children with SAB infection were 0.822,0.744 and 0.794 respectively.Conclusion High levels of mNAP,Presepsin and TREM-1 are independent risk factors influencing the short-term mortality of children with SAB infection,and mNAP,Prese
作者
刘新光
崔玉娇
王毅
王海娇
王盛华
吴昊
LIU Xin-guang;CUI Yu-jiao;WANG Yi;WANG Hai-jiao;WANG Sheng-hua;WU Hao(Department of Laboratory Medicine,Hebei Children's Hospital,Shijiazhuang 050031,China;Department of Laboratory Medicine,Shijiazhuang Obstetrics and Gynecology Hospital,Shijiazhuang 050011,China)
出处
《临床误诊误治》
CAS
2021年第8期65-69,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省医学科学研究重点课题计划(20180645)。
关键词
金黄色葡萄球菌
血流感染
中性粒细胞膜碱性磷酸酶
可溶性白细胞分化抗原14亚型
髓样细胞触发受体-1
预后
危险因素
Staphylococcus aureus
Bloodstream infection
Membrane neutrophil alkaline phosphatase
Soluble leukocyte differentiation antigen 14 subtype
Trigger receptor expressed on myeloid cell-1
Prognosis
Risk factors
