摘要
目的:探讨80例脑卒中患者感染肺炎病原菌类型分布与炎症因子表达。方法:选取2020年2月-2021年2月在山东国欣颐养集团枣庄中心医院收治的缺血性脑卒中患者80例作为卒中组,根据是否并发肺部感染将其分为肺部感染组(n=43)和未感染组(n=37);另同期随机选取健康体检人员80例作为对照组。分析肺部感染组患者病原菌分布情况。比较各组患者血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)和白细胞介素(IL)-8水平,采用Spearman等级相关性分析血清PCT、hs-CRP和IL-8水平与疾病严重程度的关系。同时随访1年,观察入组患者预后情况,比较感染组不同预后患者的血清学指标水平。结果:43例感染患者共检出病原菌68株,其中革兰阴性菌占60.29%,以铜绿假单胞菌为主,革兰阳性菌占35.30%,以金黄色葡萄球菌为主,真菌占4.41%,以白假丝酵母菌为主。感染组、未感染组患者血清PCT、hs-CRP和IL-8水平均显著高于对照组(P<0.05),且相较于未感染组,感染组患者血清PCT、hs-CRP和IL-8水平更高(P<0.05)。Spearman等级相关性分析显示,血清PCT、hs-CRP和IL-8水平均与疾病严重程度呈正相关(r=0.574、0.437、0.517,P均<0.05)。随访1年后,感染组死亡率为30.23%,明显高于未感染组的5.41%(P<0.05),感染组生存患者血清PCT、hs-CRP和IL-8水平均显著低于死亡者(P<0.05)。结论:缺血性脑卒中并发肺部感染患者的主要致病菌为革兰阴性菌,血清PCT、hs-CRP和IL-8水平呈异常升高,与患者疾病严重程度密切相关,且与患者预后存在联系。
Objective:To explore the distribution of pathogens bacteria and expressions of inflammatory factors in 80 stroke patients infected with pneumonia.Methods:A total of 80 patients with ischemic stroke were admitted to Zaozhuang Central Hospital of Shandong Guoxin Yiyang Group were enrolled as stroke group between February 2020 and February 2021.According to presence or absence of pulmonary infection,they were divided into infection group(n=43)and non-infection group(n=37).A total of 80 healthy controls during the same period were enrolled as control group.The distribution of pathogens in infection group was analyzed.The levels of serum procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP)and interleukin(IL)-8 in different groups were compared,and their relationship with disease severity was analyzed by Spearman correlation analysis.After 1 year of follow-up,the prognosis of patients was observed,and serological indexes in patients with different prognosis were compared.Results:There were 68 strains of pathogens in infection group,including Gram-negative bacteria(60.29%,mainly on Pseudomonas aeruginosa),Gram-positive bacteria(35.30%,mainly on Staphylococcus aureus)and fungi(4.41%,mainly on Candida albicans).The levels of serum PCT,hs-CRP and IL-8 were the highest in infection group,followed by non-infection group and control group(P<0.05).Spearman correlation analysis showed that levels of serum PCT,hs-CRP and IL-8 were positively correlated with disease severity(r-0.574,0.437,0.517,P<0.05).After 1 year offllow-up,mortality in infection group was significantly higher than that in non-infection group(30.23%vs 5.41%,P<0.05).The levels of serum PCT,hs-CRP and IL-8 in the survived were significantly lower than those in the dead(P<0.05).Conclusion:Gram-negative bacteria are the main pathogens in patients with ischemic stroke and pulmonary infection.The levels of serum PCT,hs-CRP and IL-8 are abnormally increased,which are closely related to disease severity and prognosis of patients.
作者
杨丽萍
田家强
YANGLi-ping;TIAN Jia-qiang(Department of Laboratory Medicine,Zaozhuang Central Hospital of Shandong Guoxin Yiyang Group,Shandong Zaozhuang 277000)
出处
《医学检验与临床》
2024年第5期21-25,共5页
Medical Laboratory Science and Clinics
