骨感染患者的血生化诊断指标研究

发布时间：2018-06-21 12:35

本文选题：溶菌酶 + 乳铁蛋白　；参考：《南京大学》2015年硕士论文

【摘要】：目的：探讨血清溶菌酶活性和乳铁蛋白含量以及常规的红细胞沉降率,CRP检测对于骨感染患者与非感染骨折患者之间的鉴别诊断价值,以及它们对于骨感染患者是否处于处于细菌活动期的评估价值。方法：骨感染患者和非感染骨折患者共29名,其中19名患者为骨感染组,10名患者为非感染骨折组；按细菌培养结果将骨感染患者分为细菌培养阳性组和细菌培养阴性组,细菌培养阳性组11人,阴性组8人。所有患者人院后48小时内抽静脉血检测血清溶菌酶活性和乳铁蛋白含量,红细胞沉降率、C反应蛋白。对比分析骨感染组和骨折组各项指标检测结果；细菌培养阳性组和细菌培养阴性组各项指标检测结果。结果：骨感染组的血清溶菌酶活性为1405.09±178.79iu/1,骨折组血清溶菌酶活性为1370.85±203.88iu/1,两组间差异无统计学意义(p0.05)；骨感染组血清乳铁蛋白含量为151.52±26.24 μg/ml,骨折组血清乳铁蛋白含量为91.46±21.74 μg/ml,两组间差异有统计学意义(p0.01)；骨感染组ESR为30.21±24.18mm/h,骨折组ESR为7.80±3.39mm/h；两组间差异有统计学意义(p0.01)。骨感染组CRP为18.65±23.96mg/l,骨折组CRP为4.17±2.39mg/l；两组间差异有统计学意义(p0.05)。骨感染组中的细菌培养阳性组血清溶菌酶活性为1368.92±180.62iu/l,细菌培养阴性组血清溶菌酶活性为1487.69±192.22iu/l,两组间差异无统计学意义(p0.05)；细菌培养阳性组血清乳铁蛋白含量为154.71±28.57mg/l,细菌培养阴性组血清乳铁蛋白含量为147.30±27.60mg/l,两组间差异无统计学意义(p0.05)。细菌培养阳性组ESR为40.36±27.44mm/h,细菌培养阴性组ESR为16.25±6.62mm/h,两组间差异有统计学意义(p0.05)；细菌培养阳性组CRP为27.54±26.61mg/l,细菌培养阴性组为16.43±10.38mg/l。两组间差异无统计学意义(p0.05)结论：传统的ESR,CRP检查尽管敏感性较差容易被其他疾病或组织损伤影响但仍是骨感染检查不可或缺的部分,ESR可以有效反应患者的细菌活动性情况。单凭血清溶菌酶检测无法鉴别骨感染和普通骨折患者；血清乳铁蛋白含量的检测对于骨感染患者诊断有一定参考价值和临床意义。但是由于本研究病例数量较少,因此对于乳铁蛋白对于骨感染患者确诊及感染状态的评估有待进一步临床研究。
[Abstract]:Objective: to investigate the value of serum lysozyme activity, lactoferrin content and erythrocyte sedimentation rate (RBC) and CRP in differential diagnosis between bone infection patients and non-infected fracture patients. And their value in evaluating whether patients with bone infection are in bacterial activity. Methods: there were 29 patients with bone infection and non-infection fracture, 19 of them were bone infection group, 10 patients were non-infection fracture group, according to the result of bacterial culture, bone infection patients were divided into two groups: positive group and negative group. Bacteria culture positive group 11 people, negative group 8 people. The serum lysozyme activity, lactoferrin content, erythrocyte sedimentation rate and C-reactive protein were measured within 48 hours after hospitalization. The indexes of bone infection group and fracture group were compared and analyzed, and the results of bacterial culture positive group and bacterial culture negative group were analyzed. Results: the serum lysozyme activity of bone infection group was 1405.09 卤178.79 IU / 1, and the serum lysozyme activity of fracture group was 1370.85 卤203.88 IU / 1. There was no significant difference between the two groups (p 0.05). The serum lactoferrin content of bone infection group was 151.52 卤26.24 渭 g / ml, the serum lactoferrin content of fracture group was 91.46 卤21.74 渭 g / ml, the difference between the two groups was statistically significant (p 0.01), the ESR of bone infection group was 30.21 卤24.18 mm / h, and that of fracture group was 7.80 卤3.39 mm / h, the difference between the two groups was significant (p 0.01). CRP in bone infection group was 18.65 卤23.96 mg / L, and that in fracture group was 4.17 卤2.39 mg / L, there was significant difference between the two groups (P 0.05). The serum lysozyme activity in the positive group was 1368.92 卤180.62iu / l, and that in the negative group was 1487.69 卤192.22iu / l, there was no significant difference between the two groups (p 0.05). The serum lactoferrin content in positive group was 154.71 卤28.57 mg / l, and that in negative group was 147.30 卤27.60 mg / l. There was no significant difference between the two groups. The ESR of positive group was 40.36 卤27.44 mm / h, and that of negative group was 16.25 卤6.62 mm / h (P < 0.05), the CRP of positive group was 27.54 卤26.61 mg / L, and that of negative group was 16.43 卤10.38 mg / L. Conclusion: although the sensitivity of traditional ESR-CRP is not easily affected by other diseases or tissue injury, ESR is still an indispensable part of bone infection examination, which can effectively reflect the bacterial activity of patients. Serum lysozyme detection alone can not distinguish bone infection from common fracture patients, and the detection of serum lactoferrin content has certain reference value and clinical significance for the diagnosis of bone infection patients. However, due to the small number of cases in this study, the evaluation of lactoferrin for the diagnosis and infection status of patients with bone infection needs further clinical research.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.2;R446.1

【参考文献】