小儿上呼吸道感染病原菌分析及血清炎症因子的辅助诊断价值

发布时间：2018-03-27 14:12

本文选题：上呼吸道感染　切入点：病原菌分布　出处：《中华医院感染学杂志》2017年17期

【摘要】：目的分析小儿上呼吸道感染病原菌分布及血清炎症因子改变的意义,为临床诊疗提供参考。方法选择2015年6月-2016年6月在医院儿科接受就诊的小儿上呼吸道感染患儿87例作为观察组,另纳入健康对照组80例;使用吸痰器采集观察组患儿呼吸道分泌物进行病原菌鉴定;同时比较两组儿童的血清炎症因子水平,并使用ROC曲线分析相关指标对小儿上呼吸道感染的诊断价值。结果观察组患儿共分离致病菌109株,其中革兰阴性菌71株占65.14%,革兰阳性菌38株占34.86%,排名前5位的病原菌依次为流感嗜血杆菌、肺炎链球菌、大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌;观察组患儿与对照组儿童血清炎症因子CRP(16.8±6.7VS5.6±3.2;t=13.59,P0.01)、TNF-α(22.6±4.3VS 4.7±2.1;t=33.71,P0.01)、PCT(0.38±0.13VS0.12±0.08;t=15.40,P0.01)比较,差异均具有统计学意义;ROC曲线分析显示:以13.49ng/L为截点值,TNF-α诊断小儿上呼吸道感染的敏感性为90.00%,特异性为89.66%,曲线下面积为0.87,其结果优于PCT、CRP。结论革兰阴性菌是小儿上呼吸道感染的主要致病菌,并且测定CRP、PCT及TNF-α水平在小儿上呼吸道感染病情的诊断及评价方面具有一定的临床意义。
[Abstract]:Objective to analyze the distribution of pathogenic bacteria and the change of serum inflammatory factors in children with upper respiratory tract infection. Methods from June 2015 to June 2016, 87 children with upper respiratory tract infection were selected as observation group and 80 healthy control group. The respiratory tract secretions of children in the observation group were collected with a sputum suction device to identify the pathogenic bacteria, and the levels of serum inflammatory factors in the two groups were compared at the same time. The ROC curve was used to analyze the diagnostic value of the related indexes in children with upper respiratory tract infection. Results 109 strains of pathogenic bacteria were isolated from children in the observation group. Among them 71 Gram-negative bacteria accounted for 65.14 and 38 Gram-positive bacteria accounted for 34.86.The top 5 pathogens were Haemophilus influenzae Streptococcus pneumoniae Escherichia coli Staphylococcus aureus Klebsiella pneumoniae. Compared with the control group, the serum inflammatory factor CRP(16.8 卤6.7VS5.6 卤3.2tU 13.59 TNF- 伪 was 22.6 卤4.3VS 4.7 卤2.1tU (33.71 卤0.01), and compared with that in the control group (0.38 卤0.13VS0.12 卤0.08), and compared with that in the control group (0.38 卤0.08 卤0.08), and compared with that in the control group (P < 0.05), and compared with that in the control group (P < 0.05), and compared with that in the control group. The results showed that the sensitivity, specificity and area under the curve of 13.49ng/L for diagnosis of upper respiratory tract infection in children were 90.00,89.66 and 0.87, respectively. Conclusion Gram-negative bacteria is superior to 13.49ng/L in the diagnosis of infantile upper respiratory tract infection. The main pathogens of respiratory tract infections, The determination of CRPnPCT and TNF- 伪 levels is of clinical significance in the diagnosis and evaluation of upper respiratory tract infection in children.
【作者单位】：咸宁市中心医院湖北科技学院附属第一医院检验科;咸宁市妇幼保健院B超室;咸宁市中心医院湖北科技学院附属第一医院肝胆外科;咸宁市中心医院湖北科技学院附属第一医院药剂科;嘉兴市南湖区中心医院内科;
【基金】：湖北省科学技术厅基金资助项目(2015CFB685)
【分类号】：R446.5;R725.6

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