肺部感染对重症急性胰腺炎患者呼吸功能及外周血炎症因子的影响

发布时间：2019-01-24 16:57

【摘要】：目的对重症急性胰腺炎伴有肺部感染患者病原菌分布进行分析,观察患者感染后肺部功能的变化,并探讨炎性因子在肺部感染的重症急性胰腺炎患者中的水平,为临床诊疗提供参考。方法分析2014年6月-2016年6月在医院接受就诊的重症胰腺炎患者的临床资料,依据患者是否并发感染将患者分为感染组64例及非感染组76例,同时纳入同期80例健康体检者为对照组,对病原菌进行鉴定分型,分析患者感染后肺功能的变化,并比较各组外周血炎症指标。结果 64例感染组患者共分离病原菌92株,其中革兰阴性菌52株占56.52%,革兰阳性菌36株占39.13%,真菌4株占4.35%;感染组患者的用力肺活量(FVC)、用力呼气容积(FEV1)、FEV1%及FEV1/FVC肺通气功能与未感染组及对照组相比差异有统计学意义(P0.05);感染组患者动脉血氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)、肺一氧化碳弥散量(DLCO)及单位肺泡容积的一氧化碳弥散量(DLCO/VA)指标与未感染组及对照组比较差异有统计学意义(P0.05);感染组患者外周血C-反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白介素-6(IL-6)及降钙素原(PCT)水平均高于未感染组及对照组,差异有统计学意义(P0.05)。结论肺部感染的重症急性胰腺炎患者以革兰阴性菌感染为主,且感染后患者肺功能受到明显影响;肺部感染患者TNF-α、CRP、PCT及IL-6水平较高,对重症急性胰腺炎患者进行TNF-α、CRP、PCT及IL-6检测具有重要价值。
[Abstract]:Objective to analyze the distribution of pathogenic bacteria in patients with severe acute pancreatitis with pulmonary infection, to observe the changes of pulmonary function after infection, and to explore the level of inflammatory factors in patients with severe acute pancreatitis. To provide reference for clinical diagnosis and treatment. Methods the clinical data of patients with severe pancreatitis admitted to hospital from June 2014 to June 2016 were analyzed. According to whether the patients were complicated with infection, the patients were divided into infected group (n = 64) and non-infected group (n = 76). At the same time, 80 healthy people were included as the control group. The pathogenic bacteria were identified and classified, the changes of pulmonary function after infection were analyzed, and the inflammatory indexes of peripheral blood were compared. Results 92 strains of pathogenic bacteria were isolated from 64 infected patients, 52 of them were Gram-negative bacteria (56.52%), 36 were Gram-positive bacteria (39.13), and 4 were fungi (4.35%). Forced vital capacity (FVC),) forced expiratory volume (FEV1), pulmonary ventilation function of FEV1% and FEV1/FVC in infected group were significantly different from those in uninfected group and control group (P0.05). In infection group, arterial partial pressure of oxygen (PaO_2), partial pressure of arterial carbon dioxide (PaCO_2), Pulmonary carbon monoxide dispersion volume (DLCO) and carbon monoxide diffusion volume per unit alveolar volume (DLCO/VA) were significantly higher than those in uninfected group and control group (P0.05). The levels of tumor necrosis factor (TNF- 伪), interleukin-6 (IL-6) and procalcitonin (PCT) in peripheral blood of infected patients were significantly higher than those of non-infected group and control group (P0.05). Conclusion Gram-negative bacteria infection is the main infection in severe acute pancreatitis patients with pulmonary infection, and the pulmonary function of the patients after infection is obviously affected. The levels of TNF- 伪, CRP,PCT and IL-6 were higher in patients with pulmonary infection. It was of great value to detect TNF- 伪, CRP,PCT and IL-6 in patients with severe acute pancreatitis.
【作者单位】：南阳医学高等专科学校第一附属医院普通外科;
【基金】：河南省科技计划基金资助项目(2013-07389)
【分类号】：R563.1;R576

【相似文献】