糖尿病足患者多药耐药菌感染经腔内治疗后血清降钙素原、C-反应蛋白及白细胞指标的变化

发布时间：2018-02-02 01:28

本文关键词： 糖尿病足多药耐药感染腔内治疗 WBC CRP PCT　出处：《中华医院感染学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨白细胞(WBC)计数、C-反应蛋白(CRP)及血清降钙素原(PCT)在经腔内治疗后糖尿病足多药耐药感染患者中的表达变化,对判断病情和预后评估的影响分析。方法选取医院2012年1月-2015年12月治疗的糖尿病足感染(DFI)患者115例,并且感染部位分泌物培养均呈多药耐药菌(MDRMs)阳性;根据不同的治疗方式随机分为研究组59例和对照组56例,对照组患者采用胰岛素与抗菌药物常规治疗;研究组在对照组治疗基础上采用腔内介入治疗,以治疗后1、3、7d为观察期,比较两组患者在治疗前和观察期的WBC计数、CRP及PCT指标水平变化。结果研究组WBC在治疗1、3、7d后分别为(19.48±2.71)×109/L、(12.15±1.13)×109/L、(8.92±0.46)×109/L比对照组的(23.15±3.09)×109/L、(16.49±2.37)×109/L、(10.28±0.54)×109/L略低(P均0.05);研究组的CRP在治疗1、3、7d的指标为(119.48±12.53)mg/L、(82.37±5.85)mg/L、(68.14±4.62)mg/L明显低于对照组的(123.82±13.32)mg/L、(116.53±12.04)mg/L、(101.83±6.59)mg/L(P均0.05);治疗1、3、7d后研究组患者的PCT为(2.45±0.37)μg/L、(1.78±0.24)μg/L、(0.95±0.16)μg/L比对照组PCT(3.23±0.54)μg/L、(2.17±0.36)μg/L、(2.04±0.09)μg/L下降明显(P均0.05)。结论腔内治疗糖尿病足多药耐药菌感染患者,能够加速患者创口愈合,减轻患者痛苦,将WBC、CRP及PCT指标水平控制在理想水平,尤其是对于抗菌药物控制不佳的MDRMs感染患者,具有创伤小、操作简单、效果良好,降低感染复发的优势,值得临床推荐应用。
[Abstract]:Objective to investigate the expression of C- reactive protein (CRP) and serum procalcitonin (PCT) in patients with diabetic foot multidrug resistance (MDR) infection after intracavitary treatment. Methods 115 patients with diabetic foot infection were selected from January 2012 to December 2015 in our hospital. And the secretion culture of infection site showed MDRMspositive. According to different treatment methods, 59 cases in the study group and 56 cases in the control group were randomly divided into two groups. The patients in the control group were treated with routine insulin and antimicrobial drugs. The study group was treated with intracavitary interventional therapy on the basis of the treatment in the control group. The WBC counts of the two groups were compared before and during the observation period. Results the level of WBC in the study group was 19.48 卤2.71 脳 10 ~ 9 / L after treatment for 1 ~ 3 ~ 3 ~ 7 days, respectively. Compared with the control group (12.15 卤1.13) 脳 10 9 / L, 8.92 卤0.46 脳 10 9 / L and 23.15 卤3.09 脳 10 9 / L, respectively. 10.28 卤0.54) 脳 10 ~ 9 / L, P < 0.05 ~ 0. 05%, respectively, of 16.49 卤2.37) 脳 10 ~ (9) / L and 10.28 卤0.54 脳 10 ~ (9) 路L ~ (-1) / L; The index of CRP in the study group was 119.48 卤12.53 mg / L, 82.37 卤5.85 mg / L for 7 days after treatment. 68.14 卤4.62 mg / L was significantly lower than that of control group (123.82 卤13.32 mg / L, 116.53 卤12.04 mg / L). 101.83 卤6.59 mg / L P 0.05g / L; The PCT of the patients in the study group was 2.45 卤0.37 渭 g / L, 1.78 卤0.24 渭 g / L after treatment for 1 day and 3 days later. Compared with PCT(3.23 卤0.54 渭 g / L, PCT(3.23 卤0.54 渭 g / L was 2.17 卤0.36 渭 g / L, respectively. Conclusion endovascular treatment of diabetic foot with multidrug resistant bacteria infection can accelerate wound healing and alleviate the pain of diabetic foot. The levels of WBC C C C P and PCT were controlled at the ideal level, especially for the patients with MDRMs infection with poor control of antimicrobial agents, which had the advantages of less trauma, simple operation and good effect. The advantage of reducing the recurrence of infection is worthy of clinical recommendation.
【作者单位】：沈阳医学院附属第二医院血管外科;
【分类号】：R587.2
【正文快照】： 糖尿病足是糖尿病并发症中常见的一种[1],是由于患者发生神经性病变使下肢保护功能逐渐减弱,而下肢组织中的大血管和微血管发生病变导致动脉的灌注不足,血液微循环产生障碍而引发的足部溃疡和坏疽的现象。研究显示,在糖尿病患者中的糖尿病足发病率约为20%,我国每年有10%左右的

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