中性粒细胞CD64对自发性细菌性腹膜炎抗生素应用的指导价值

发布时间：2018-02-09 19:44

  本文关键词： 中性粒细胞CD 乙肝肝硬化 自发性细菌性腹膜炎 抗生素　出处：《中国现代医学杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的探讨中性粒细胞CD64对乙肝肝硬化并发自发性细菌性腹膜炎(SBP)应用抗生素的指导价值。方法将134例乙肝肝硬化并发SBP患者随机分为CD64组(73例)和对照组(61例),CD64组根据中性粒细胞CD64作为开始和停用抗生素的依据;对照组按照常规方法应用抗生素。比较两组患者的抗生素疗程、抗生素费用、住院时间、住院费用、Child-Pugh评分、MELD评分、临床有效率及病死率。结果 CD64组抗生素疗程8 d(6~14 d)、抗生素费用781元(458~4 297元)、住院时间15 d(6~29 d)、住院费用7 328元(4 951~13 916元)均低于对照组分别为11 d(7~20 d),1 084元(728~5 822元),20 d(10~35 d),10 239元(5 325~19 824元)。治疗结束后CD64组与对照组患者Child-pugh评分[(9.26±3.24)vs(9.72±3.12)]、MELD评分[(16.16±8.04)vs(15.71±8.13)]、临床有效率(90.41%vs 91.80%)和病死率(4.11%vs 3.28%)比较,均差异无统计学意义(均P0.05)。结论中性粒细胞CD64可作为乙肝肝硬化并发SBP患者临床抗生素应用的参考指标,并能够缩短抗生素使用时间和住院天数。
[Abstract]:Objective to investigate the value of neutrophil CD64 in the application of antibiotics in patients with hepatitis B cirrhosis complicated with spontaneous bacterial peritonitis. Methods 134 patients with hepatitis B cirrhosis complicated with SBP were randomly divided into CD64 group (n = 73) and control group (n = 61). Neutrophil CD64 was used as the basis for the initiation and discontinuation of antibiotics. The patients in the control group were treated with antibiotics according to the routine method. The course of antibiotic treatment, the cost of antibiotics, the length of hospitalization, the Child-Pugh score and meld score were compared between the two groups. Results the clinical effective rate and mortality rate in CD64 group were lower than those in control group (11 days, 720 days, 1084 days, 781 yuan, 458min, 4297 yuan, 15 days, 629 days, 7 328 yuan / 4 951U 13 916), respectively, which were lower than those in the control group (11 days, 720 days, 1 084 days, 728 yuan, 5 822 yuan), respectively, in the CD64 group, the course of antibiotic treatment was 8 days, the course of treatment was 6 days, the cost of antibiotics was 781 yuan, the cost of antibiotics was 4 297 yuan. After treatment, the Child-pugh score of CD64 group and control group [9.26 卤3.24 vs 9.72 卤3.12)] meld score [16.16 卤8.04 vs 15.71 卤8.13], the clinical effective rate was 90.41 vs 91.80) and the mortality was 4.11m vs 3.28). Conclusion neutrophil CD64 can be used as a reference index for the clinical use of antibiotics in patients with hepatitis B cirrhosis complicated with SBP, and can shorten the duration of antibiotic use and hospital stay.
【作者单位】： 福建医科大学孟超肝胆医院(福州市传染病医院);
【基金】：福州市卫生系统科技计划项目(No:2016-S-wq7)
【分类号】：R512.62;R572.2;R575.2
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