重症肺炎患者病原菌分布与C-反应蛋白和白细胞介素-6及白细胞介素-10的变化研究

发布时间：2018-06-05 05:51

本文选题：重症肺炎 + 病原菌　；参考：《中华医院感染学杂志》2017年11期

【摘要】：目的研究重症肺炎患者病原菌分布及C-反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)的变化,为临床诊治提供参考。方法选取2014年5月-2016年4月医院收治的重症肺炎患者160例为观察组,并同期选择130名健康体检者为对照组,分析感染患者的病原菌分布,并采用酶联免疫吸附测定法检测患者感染病原菌后血清CRP、IL-6及IL-10的水平变化。结果观察组患者分离出病原菌176株,其中革兰阴性菌104株占59.1%,革兰阳性菌33株占18.7%,真菌39株占22.2%;革兰阴性菌中铜绿假单胞菌对阿米卡星的耐药率最低,其次是哌拉西林和美罗培南,肺炎克雷伯菌对亚胺培南的耐药率最低,其次是美罗培南和头孢哌酮,不动杆菌属对头孢哌酮的耐药率最低;革兰阳性菌中金黄色葡萄球菌和表皮葡萄球菌均对青霉素的耐药率最高,屎肠球菌对环丙沙星和青霉素的耐药率最高;另外患者感染病原菌后血清CRP、IL-6以及IL-10表达水平均明显高于健康的体检者,两组比较差异有统计学意义(P0.05)。结论重症肺炎患者病原菌是以革兰阴性菌为主,对抗菌药物具有较高的耐药性,且血清CRP、IL-6及IL-10水平均明显升高。
[Abstract]:Objective to study the distribution of pathogenic bacteria in patients with severe pneumonia and the changes of C- reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10) in order to provide reference for clinical diagnosis and treatment. Methods 160 patients with severe pneumonia treated in hospital from May 2014 to April 2016 were selected as observation group and 130 healthy persons as control group. The distribution of pathogenic bacteria in infected patients was analyzed. The levels of serum CRP- 6-6 and IL-10 were detected by enzyme-linked immunosorbent assay (Elisa). Results 176 strains of pathogenic bacteria were isolated from patients in the observation group, of which 104 strains were Gram-negative bacteria (59.1%), 33 Gram-positive bacteria (18.7%) and 39 fungi strains (22.2B), among them, Pseudomonas aeruginosa had the lowest resistance to amikacin. The resistance rate of Klebsiella pneumoniae to imipenem was the lowest, meropenem and cefoperazone was the second, Acinetobacter spp. Among Gram-positive bacteria, Staphylococcus aureus and Staphylococcus epidermidis had the highest resistance to penicillin, while Enterococcus faecium had the highest resistance to ciprofloxacin and penicillin. In addition, the expression levels of serum CRPU IL-6 and IL-10 in patients infected with pathogenic bacteria were significantly higher than those in healthy controls. The difference between the two groups was statistically significant (P 0.05). Conclusion Gram-negative bacteria are the main pathogens in patients with severe pneumonia, which have high resistance to antibiotics, and the serum levels of CRPP-IL-6 and IL-10 are significantly increased.
【作者单位】：新乡市中心医院急诊科;新乡市中心医院检验科;新乡市中心医院特需三科;
【基金】：新乡市重点科技攻关基金资助项目(ZG15032)
【分类号】：R563.1

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