摘要
目的分析重症医学科(ICU)脓毒症患者病原菌状况及降钙素原(PCT)、C-反应蛋白(CRP)、乳酸水平。方法选择2016年4月-2018年1月医院ICU 105例脓毒症患者为研究组(脓毒症58例、严重脓毒症24例、脓毒症休克20例),并以同期入住ICU的非脓毒症患者80例为对照组,分析研究组患者病原菌感染、分布,分析所有研究对象PCT、CRP、乳酸水平。结果研究组患者共检出病原菌151株,其中革兰阴性菌81株占53.64%,革兰阳性菌55株占36.42%,真菌15株占9.93%;研究组PCT、CRP、乳酸水平均高于对照组(P<0.05),脓毒症、严重脓毒症、脓毒症休克患者PCT、CRP、乳酸水平呈上升趋势(P<0.05);研究组急性生理与慢性健康评分(APACHEⅡ评分)高于对照组(P<0.05);严重脓毒症、脓毒症休克APACHEⅡ评分均高于脓毒症患者(P<0.05),严重脓毒症与脓毒症休克患者比较差异无统计学意义;脓毒症患者PCT、CRP水平与APACHEⅡ评分呈正相关(P<0.05)。结论 ICU脓毒症感染病原菌以革兰阴性菌为主,患者PCT、CRP、乳酸水平与疾病发生发展关系密切,临床中应加强监测并及时进行有效干预。
OBJECTIVE To analyze the etiological characteristics of the sepsis patients of intensive care unit(ICU)and observe the levels of blood parameters such as procalcitonin(PCT),C-reactive protein(CRP)and lactic acid.METHODS A total of 105 sepsis patients who were treated in ICU from Apr 2016 to Jan 2018 were chosen as the study group,including 58 cases of sepsis,24 cases of severe sepsis and 20 cases of septic shock,meanwhile,80 non-sepsis patients who were treated in ICU were set as the control group.The distribution of pathogens was analyzed,the levels of PCT,CRP and lactic acid of all the study objects were observed.The correlation between PCT,CRP and Acute Physiology and Chronic Health Evaluation(APACHE)II score was analyzed.RESULTS Totally 151 strains of pathogens were isolated from the patients in the study group,81(53.64%)of which were gram-negative bacteria,55(36.42%)were gram-positive bacteria,and 15(9.93%)were fungi.The levels of PCT,CRP and lactic acid of the study group were significantly higher than those of the control group(P<0.05).The levels of PCT,CRP and lactic acid of the patients with sepsis,severe sepsis and septic shock showed upward trends(P<0.05).The APACHE II score of the study group was significantly higher than that of the control group(P<0.05).The APACHE II score of the patients with severe sepsis and septic shock was significantly higher than that of the patients with sepsis(P<0.05).The levels of PCT and CRP of the sepsis patients were positively corelated with the APACHE II score(P<0.05).CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the ICU patients with sepsis,the emergence and progression of the disease are closely associated with the levels of PCT,CRP and lactic acid,and it is necessary for the hospital to strengthen the monitoring and take effective intervention measures.
作者
陈静
龚宗炼
葛颖
杨明
张丽
CHEN Jing;GONG Zong-lian;GE Ying;YANG Ming;ZHANG Li(Affiliated Hospital of Chuanbei Medical College,Nanchong,Sichuan 637000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第17期2571-2574,共4页
Chinese Journal of Nosocomiology
基金
四川省卫生厅科学研究基金资助项目(100159)
