鲍氏不动杆菌医院获得性肺炎患者免疫功能及预后分析

发布时间：2018-12-25 10:37

【摘要】：目的探讨重症监护病房中多药耐药鲍氏不动杆菌(MDRAB)医院获得性肺炎(HAP)患者的免疫功能,各免疫指标对医院感染的预测价值及对预后的影响,以更好地指导临床工作,降低患者病死率。方法采用病例对照研究方法,回顾性分析2011年6月-2016年6月广西医科大学第一附属医院MDRAB HAP 87例为病例组,并选取同时期非MDRAB HAP 62例为对照组,比较两组患者T淋巴细胞、B淋巴细胞、免疫球蛋白、NK细胞计数等免疫指标及降钙素原、C-反应蛋白、白细胞等炎性指标,观察各免疫指标及炎性指标对医院感染的预测作用,应用单因素分析法进行比较两组中各免疫指标及炎性指标有无差异;应用ROC曲线评估各指标对医院感染的预测价值。结果 APACHEⅡ评分差异有统计学意义(P0.05);对于免疫指标,两组总T细胞、CD_8~+T淋巴细胞、免疫球蛋白M、免疫球蛋白G、NK细胞均无统计学意义,但两组中CD_4~+T淋巴细胞差异有统计学意义(P0.05),免疫球蛋白A水平有显著差异(P0.05),绘制CD_4~+T淋巴细胞和免疫球蛋白A预测HAP的ROC曲线均具有较大诊断价值;炎性指标的研究中,患者白细胞计数、中性粒细胞百分比、降钙素原、C-反应蛋白比较差异无统计学意义,但淋巴细胞差异有统计学意义(P0.05)。结论免疫指标CD_4~+T细胞、免疫球蛋白A、APACHEⅡ评分对指导重症监护病房中HAP患者的临床治疗有重要价值,对MDRAB HAP患者的免疫功能及其预后的评估具有重要意义。
[Abstract]:Objective to investigate the immune function of (HAP) patients with multidrug resistant Acinetobacter baumannii (MDRAB) hospital acquired pneumonia in intensive care unit (ICU), the predictive value of each immune index to nosocomial infection and its influence on prognosis, so as to better guide the clinical work. Reduce the mortality of patients. Methods from June 2011 to June 2016, 87 cases of MDRAB HAP in the first affiliated Hospital of Guangxi Medical University were analyzed retrospectively, and 62 cases of non-MDRAB HAP in the same period were selected as the control group. The T lymphocytes were compared between the two groups. B lymphocyte, immunoglobulin, NK cell count, procalcitonin, C-reactive protein, leukocyte and other inflammatory indexes were observed to predict nosocomial infection. Single factor analysis was used to compare the difference of immune and inflammatory indexes between the two groups. ROC curve was used to evaluate the predictive value of each index for nosocomial infection. Results there was significant difference in APACHE 鈪，

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