摘要
目的 探讨中性粒细胞/淋巴细胞比值(NLR)、C反应蛋白(CRP)、降钙素原(PCT)、血清淀粉样蛋白A(SAA)、白细胞介素-6(IL-6)和CD64指数对细菌性血流感染早期诊断和预后评估的价值.方法 选取2019年1月—2023年6月上海交通大学医学院附属第九人民医院细菌性血流感染患者380例,以血培养阴性的住院患者100例作为对照组.检测所有研究对象NLR、CRP、PCT、SAA、IL-6和CD64指数.根据病原菌的类型分为革兰阳性(G+)菌组(105例)和革兰阴性(G-)菌组(275例).380例患者中有210例并发脓毒症,依据其生存情况分为死亡组(40例)和生存组(170例).结果 G+菌血流感染患者主要来自急诊科、普外科和普外重症监护病房,以金黄色葡萄球菌、屎肠球菌和表皮葡萄球菌为主;G-菌血流感染患者主要来自普外重症监护病房、普外科和血液内科,以大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌为主.G+菌组和G-菌组NLR、CRP、PCT、SAA、IL-6和CD64指数均显著高于对照组(P<0.05).G-菌组PCT、IL-6和CD64指数均高于G+菌组(P<0.05),2个组之间NLR、CRP、SAA差异均无统计学意义(P>0.05).死亡组NLR、PCT、CRP、SAA、IL-6、CD64指数均显著高于生存组(P<0.05).结论 NLR、CRP、PCT、SAA、IL-6和CD64指数在细菌性血流感染的诊断和预后评估中均有较高的价值.PCT、IL-6和CD64指数有助于区分血流感染的细菌类型.
Abstract
Objective To investigate the roles on early diagnosis and prognosis of neutrophil-lymphocyte ratio(NLR),C-reactive protein(CRP),procalcitonin(PCT),serum amyloid A(SAA),interleukin-6(IL-6)and CD64 index for bloodstream infection.Methods Totally,380 patients with bacterial bloodstream infection were enrolled as bloodstream infection group from Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from January 2019 to June 2023.A total of 100 inpatients with negative blood culture were enrolled as control group.The NLR,CRP,PCT,SAA,IL-6 and CD64 index were determined.According to the types of infecting bacteria,the subjects were classified into Gram-positive(G+)bacterium group(105 cases)and Gram-negative(G-)bacterium group(275 cases).Among the 380 patients,210 patients were complicated by sepsis,which were classified into death group(40 cases)and survival group(170 cases)based on their survival status.Results The patients in G+ bacteria induced bloodstream infection were mainly from emergency department,general surgery department and general surgery intensive care unit,and Staphylococcus aureus,Enterococcus faecium and Staphylococcus epidermis were the main ones.The patients in G-bacteria induced bloodstream infection were mainly from general surgery intensive care unit,general surgery department and hematology department,which were mainly composed of Escherichia coli,Klebsiella pneumoniae and Acinetobacter baumannii.The NLR,CRP,PCT,SAA,IL-6 and CD64 index in G+ and G-bacterium groups were higher than those in control group(P<0.05).The PCT,IL-6 and CD64 index in G-bacterium group were higher than those in G+ bacterium group(P<0.05),and there was no statistical significance in NLR,CRP and SAA between the 2 groups(P>0.05).The NLR,PCT,CRP,SAA,IL-6 and CD64 index in death group were higher than those in survival group(P<0.05).Conclusions NLR,CRP,PCT,SAA,IL-6 and CD64 index have efficacy in the diagnosis and prognosis of bloodstream infection.PCT,IL-6 and CD64 index may distinguish infecting bacterial types in bloodstream infection.
基金项目
上海市浦东新区卫生健康委卫生计生科研项目(PW2021B-07)
NETL
NSTL
万方数据