呼吸机相关性肺炎患者感染病原菌分布与降钙素原和C-反应蛋白及乳酸变化的研究

发布时间：2018-08-24 21:09

【摘要】：目的研究呼吸机相关性肺炎患者病原菌分布情况,并对患者降钙素原(PCT)、C-反应蛋白(CRP)和乳酸水平进行检测,为临床诊断和治疗提供参考,并讨论呼吸机相关性肺炎的预防对策。方法选择2015年1月-2016年1月医院确诊并治疗的103例呼吸机相关性肺炎患者为感染组,根据患者疾病预后分为好转组(54例)和恶化组(49例);并分别选择同期于医院进行呼吸机治疗未合并感染的112名患者为未感染组,选择进行健康体检的98例患者为健康组;对感染组患者进行病原菌分布情况分析,同时对所有对象进行CRP、PCT和乳酸水平的检测。结果感染组患者中共分离出病原菌118株,革兰阴性菌和革兰阳性菌构成比分别为57.63%和41.53%;感染组患者CRP和PCT水平均明显高于未感染组和健康组(P0.05),感染组中病情好转患者CRP和PCI水平明显低于恶化组(P0.05),好转组患者在进行插管治疗后各时间点的乳酸水平均明显低于恶化组(P0.05)。结论呼吸机相关性肺炎患者病原菌分布以革兰阴性菌为主,且患者PCT、CRP和乳酸水平均明显升高。
[Abstract]:Objective to study the distribution of pathogenic bacteria in patients with ventilator-associated pneumonia and to detect the levels of calcitonin proto (PCT) C-reactive protein (CRP) and lactate in order to provide reference for clinical diagnosis and treatment, and to discuss the preventive measures of ventilator-associated pneumonia. Methods 103 patients with ventilator-associated pneumonia diagnosed and treated in hospital from January 2015 to January 2016 were selected as infection group. According to the prognosis of the patients, the patients were divided into two groups: improvement group (54 cases) and deterioration group (49 cases), 112 patients who were treated with ventilator in hospital at the same time as uninfected group and 98 patients who underwent physical examination were selected as healthy group. The distribution of pathogenic bacteria and the levels of CRP,PCT and lactic acid in all patients were analyzed. Results 118 strains of pathogenic bacteria were isolated from infected patients. The composition ratio of Gram-negative bacteria and Gram-positive bacteria were 57.63% and 41.53.The levels of CRP and PCT in the infected group were significantly higher than those in the uninfected group and the healthy group (P0.05). The levels of CRP and PCI in the infected group were significantly lower than those in the worsening group (P0.05), and the levels of PCI in the improved group were significantly higher than those in the control group (P0.05). The lactic acid levels at each time point after intubation were significantly lower than those in the exacerbation group (P0.05). Conclusion Gram-negative bacteria are the main pathogens in patients with ventilator-associated pneumonia, and the levels of PCT,CRP and lactic acid are significantly increased.
【作者单位】：海南省农垦总医院呼吸内科;
【基金】：海南省卫生厅基金资助项目(琼卫2012PT-35)
【分类号】：R563.1

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