摘要
目的探讨白细胞计数(WBC)、中性粒细胞与淋巴细胞比值(NLR)、降钙素原(PCT)对病原菌感染的早期诊断价值,了解ICU患者病原菌感染及耐药现状。方法回顾性分析2016~2020年云南省第一人民医院ICU收治的402例病原菌感染住院患者的临床资料及实验室资料,根据不同病原菌类型将其分为革兰阳性菌感染(n=77)、革兰阴性菌感染(n=277)及真菌感染(n=48),根据感染部位分为血流感染(n=136)和局部感染(n=266),分析病原菌培养结果,比较不同感染部位及不同类型病原菌感染患者血清PCT、NLR及WBC水平,绘制受试者工作特征(Receiver operating characteristic,ROC)曲线。结果ICU病原菌主要以大肠埃希菌、鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌及金黄色葡萄球菌为主。血流感染患者血清PCT及NLR高于局部感染患者(P>0.05)。ROC曲线下面积比较,PCT>三项联合检测>NLR>WBC,PCT曲线下面积最大(0.709),最佳临界值为10.88ng/ml,其敏感度和特异性分别为61.8%和76.3%。结论ICU病原菌以耐药菌为主,其耐药率呈逐年增加趋势。PCT对血流感染有一定预测价值。
Objective To assess the early diagnostic value of white blood cell count(WBC),neutrophil-tolymphocyte ratio(NLR),procalcitonin(PCT)in pathogen infection,understand the current status of pathogen infection and drug resistant in ICU patients.Methods The clinical and laboratory data of 402 hospitalized patients with pathogen infection in ICU of The First People’s Hospital of Yunnan Province from 2016 to 2020 were retrospectively analyzed.According to different pathogen infections,the patients were divided into Gram-positive bacteria infection(n=77),Gram-negative bacteria infection(n=277)and fungal infection(n=48).According to the infection sites,the patients were divided into blood flow infection(n=136)and local infection(n=266).Analyzed the culture results of pathogen,compared the serum levels of PLT,NLR and WBC in patients with different infection sites and different types of pathogen infection,and drew the receiver operating characteristic(ROC)curve.Results Escherichia coli,acinetobacter baumannii,klebsiella pneumoniae,pseudomonas aeruginosa and staphylococcus aureus were the predominant species in ICU.The levels of NLR and PCT in blood flow infection patients were significantly higher than those in local infection patients.Compared the area under ROC curve,PCT>combined detection of three indicators>NLR>WBC,the area under curve of PCT(0.709)was the largest,the cut-off value was 10.88 ng/ml,and sensitivity and specificity was 61.8%and 76.3%respectively.Conclusion The pathogens are mainly drug-resistant bacteria,and the drug resistance rate is increasing year by year in ICU.PCT level has a certain predictive value for blood infection.
作者
杨艳
薛晋芳
娄熙冉
宁得源
陈国兵
Yang Yan;Xue Jinfang;Lou Xiran(School of Medical,Kunming University of Science and Technology,Kunming 650500)
出处
《中国现代医药杂志》
2022年第2期26-32,共7页
Modern Medicine Journal of China
关键词
病原菌感染
降钙素原
中性粒细胞与淋巴细胞比值
白细胞
ROC曲线
Pathogen infection
Procalcitonin
Neutrophil-to-lymphocyte ratio
White blood cell
Receiver operating characteristic curve
