弥漫性脑损伤合并肺部感染患者神经损伤及炎症因子的变化观察

发布时间：2018-05-17 13:01

  本文选题：弥漫性脑损伤 + 肺部感染　； 参考：《中华医院感染学杂志》2017年10期

【摘要】：目的分析弥漫性脑损伤合并肺部感染患者神经损伤及炎症介质因子指标的变化,为临床治疗提供指导依据。方法选取2014年1月-2016年1月医院收治的弥漫性脑损伤患者66例为研究对象,针对患者的临床感染情况、炎症因子指标水平、感染病原菌及药敏情况进行统计分析。结果 66例弥漫性脑损伤患者中,发生感染25例,感染率为37.88%;感染患者和非感染患者的神经细丝酸性蛋白、肌酸激酶同工酶和髓鞘碱性蛋白等神经损伤指标差异无统计学意义;感染患者的C-反应蛋白(CRP)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子α(TNF-α)、白介素-1(IL-1)水平分别为(40.87±5.34)mg/L、(337.24±23.45)pg/ml、(540.83±46.93)pg/ml、(95.92±8.62)pg/ml和(0.99±0.11)ng/L,均高于非感染患者的(30.82±3.57)mg/L、(259.45±16.83)pg/ml、(469.74±44.83)pg/ml、(84.44±7.45)pg/ml和(0.31±0.01)ng/L,且差异有统计学意义(P0.01);25例感染患者共分离出病原菌30株,其中革兰阴性菌21株、革兰阳性菌8株、真菌1株,分别占70.00%、26.67%和3.33%;革兰阴性菌对氨曲南和亚胺培南的敏感度高,对氨苄西林、哌拉西林、头孢噻肟和头孢曲松等耐药性高,革兰阳性菌对青霉素和庆大霉素的耐药性高,对利福平的敏感度高。结论弥漫性脑损伤合并肺部感染患者的神经损伤情况较未感染患者差异不大,但其炎症因子水平显著升高,同时导致患者感染的病原菌以革兰阴性菌为主,临床治疗应根据药敏结果采取敏感的抗菌药实施针对性治疗。
[Abstract]:Objective to analyze the changes of nerve injury and inflammatory mediators in patients with diffuse brain injury complicated with pulmonary infection, and to provide guidance for clinical treatment. Methods 66 patients with diffuse brain injury were selected from January 2014 to January 2016. The clinical infection, the level of inflammatory factors, the pathogenic bacteria and the drug sensitivity of the patients were statistically analyzed. Results among 66 patients with diffuse brain injury, 25 cases were infected, the infection rate was 37.88, and there was no significant difference in neurofilament acidic protein, creatine kinase isoenzyme and myelin basic protein between infected patients and non-infected patients. 鎰熸煋鎮ｈ，

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