中性粒细胞碱性磷酸酶对骨科患者感染的诊断研究

发布时间：2018-04-27 07:35

本文选题：中性粒细胞碱性磷酸酶 + 骨科　；参考：《中华医院感染学杂志》2017年14期

【摘要】：目的探讨中性粒细胞碱性磷酸酶(NAP)在骨科患者感染中的诊断价值。方法选取2011年1月-2016年3月医院骨科进行I类手术的患者6253例,发生感染患者为感染组,在未发生感染的患者中随机选取300例作为非感染组,术后1d,抽取外周静脉血,检测降钙素原(PCT),C-反应蛋白(CRP)和NAP,对感染患者进行病原菌检测。结果 6253例患者中共282例发生医院感染,医院感染率为4.5%;感染组NAP阳性率、NAP积分、CRP和PCT均显著高于非感染组,差异有统计学意义(P0.05);282例感染患者共检出病原菌282株,其中革兰阳性菌126株,占44.68%,革兰阴性菌120株,占42.55%,支原体14株,占4.96%,病毒12株,占4.26%,其他菌株10株,占3.55%;革兰阴性菌感染患者NAP阳性率(99.53±0.15)和积分(452.36±65.28)均显著高于革兰阳性菌感染患者的(86.33±5.17)和(292.15±46.37),两组数据比较差异有统计学意义(P0.05),而革兰阴性菌和革兰阳性菌感染患者CRP和PCT相比,差异无统计学意义;革兰阳性菌感染患者CRP(246.18±50.52)mg/L和PCT(1.25±0.26)ug/L显著高于支原体感染患者的(135.35±35.15)mg/L和PCT(1.01±0.33)ug/L,两组数据比较差异有统计学意义(P0.05),而革兰阳性菌和支原体感染患者NAP阳性率和积分相比,差异无统计学意义。结论 NAP活性检测在骨科患者感染诊断方面具有重要临床价值,对于快速诊断和疗效判断具有重要意义。
[Abstract]:Objective to investigate the diagnostic value of neutrophil alkaline phosphatase (NAPs) in orthopedic patients. Methods from January 2011 to March 2016, 6253 patients undergoing Class I surgery in orthopedic department of hospital were selected as infection group, and 300 patients without infection were randomly selected as non-infection group. Peripheral venous blood was extracted 1 day after operation. C- reactive protein (CRP) and NAPs of procalcitonin (PCT) were detected to detect pathogenic bacteria in infected patients. Results the nosocomial infection occurred in 6253 patients, the nosocomial infection rate was 4.5.The positive rate of NAP in the infected group was significantly higher than that in the non-infection group, and the difference was statistically significant (P 0.05). Of these, 126 were Gram-positive bacteria (44.68), 120 Gram-negative bacteria (42.55), 14 mycoplasma (4.96), 12 viruses (4.26), and 10 other strains. The positive rate of NAP in the patients with Gram-negative bacteria infection was 99.53 卤0.15) and the score was 452.36 卤65.28), which was significantly higher than that in the patients with Gram-positive bacteria infection (86.33 卤5.17) and the patients with Gram-positive bacteria infection (292.15 卤46.37g). The difference between the two groups was statistically significant (P 0.05), while the CRP and PCT of the patients with Gram-negative bacteria and Gram-positive bacteria infection were significantly higher than those of the patients with Gram-positive bacteria infection. CRP(246.18 卤50.52)mg/L and PCT(1.25 卤0.26)ug/L in patients with Gram-positive bacilli infection were significantly higher than those in patients with mycoplasma infection (135.35 卤35.15)mg/L and PCT(1.01 卤0.33ug-L). The difference between the two groups was statistically significant (P 0.05), but the positive rate and score of NAP in patients with Gram-positive bacteria and mycoplasma infection were higher than those in patients with mycoplasma infection. The difference was not statistically significant. Conclusion the detection of NAP activity has important clinical value in the diagnosis of infection in orthopedic patients, and is of great significance for rapid diagnosis and evaluation of curative effect.
【作者单位】：浙江省嘉兴市第二医院骨科;浙江省嘉兴市第二医院麻醉科;
【基金】：浙江省嘉兴市科技局基金资助项目(2014AY21031)
【分类号】：R687.3

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