摘要
目的探讨5项常用感染指标联合4项血清蛋白指标检测在成人下呼吸道鲍曼不动杆菌感染和定植鉴别诊断中的应用价值。方法选取2021年1-12月西安大兴医院下呼吸道标本培养出鲍曼不动杆菌的140例患者作为研究对象,根据下呼吸道细菌感染或定植临床诊断标准分为感染组(70例)和定植组(70例)。比较两组鲍曼不动杆菌耐药性差异,比较两组感染指标和血清蛋白指标水平,绘制受试者工作特征曲线(ROC曲线)分析感染指标联合血清蛋白指标鉴别下呼吸道鲍曼不动杆菌感染和定植的价值。结果感染组白细胞计数为(13.53±1.47)×10^(9)/L,中性粒细胞计数为(11.73±1.41)×10^(9)/L,C反应蛋白为(97.07±5.95)mg/L,超敏C反应蛋白为(99.74±6.29)mg/L,降钙素原为(4.20±0.71)ng/mL,球蛋白(GLO)为(26.65±6.61)g/L,均明显高于定植组的(8.64±0.50)×10^(9)/L、(6.64±0.51)×10^(9)/L、(31.37±4.61)mg/L、(31.29±4.56)mg/L、(0.15±0.10)ng/mL、(22.28±4.28)g/L,差异均有统计学意义(P<0.05)。感染组总蛋白为(56.66±8.89)g/L、清蛋白(ALB)为(29.84±5.37)g/L、ALB/GLO(A/G)为1.18±0.28,均明显低于定植组的(60.52±5.79)g/L、(37.79±3.94)g/L、1.76±0.40,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,9项指标联合检测鉴别下呼吸道鲍曼不动杆菌感染和定植的曲线下面积最大,为0.981(0.964~0.998),其灵敏度为95.70%,特异度为92.90%,阳性预测值为93.10%,阴性预测值为95.60%。结论5项常用感染指标联合4项血清蛋白指标检测在下呼吸道鲍曼不动杆菌感染和定植鉴别诊断中有较好的价值。
Objective To explore the value of five common infection indexes combined with four serum protein indexes in the differential diagnosis of adult with lower respiratory tract Acinetobacter baumannii infection and colonization.Methods A total of 140 patients with Acinetobacter baumannii cultured from lower respiratory tract were selected of Xi′an Daxing hospital from January 2021 to December 2021.According to the clinical diagnosis and etiological diagnosis criteria of lower respiratory tract bacterial infection or colonization,the patients were divided into infection group(n=70)and colonization group(n=70).Differences of drug resistance of Acinetobacter baumannii between the two groups were compared,as well as the levels of infection indexes and serum protein indexes in each group,the receiver operating characteristic curve(ROC curve)was draw to analyze the value of infection indexes combined with serum protein indexes in identifying lower respiratory tract infection and colonization of Acinetobacter baumannii.Results White blood cell count of the infection group was(13.53±1.47)×10^(9)/L,Neutrophil count was(11.73±1.41)×10^(9)/L,C-reactive protein was(97.07±5.95)mg/L,high sensitivity C-reactive protein was(99.74±6.29)mg/L,procalcitonin was(4.20±0.71 ng/mL)and globulin(GLO)was(26.65±6.61)g/L,which were significantly higher than those in the colonization group[(8.64±0.50)×10^(9)/L,(6.64±0.51)×10^(9)/L,(31.37±4.61)mg/L,(31.29±4.56)mg/L,(0.15±0.10)ng/mL,(22.28±4.28)g/L],the differences were statistically significant(P<0.05).Total protein[(56.66±8.89)g/L],albumin(ALB)[(29.84±5.37)g/L]and A/G(1.18±0.28)in the infection group were significantly lower than TP[(60.52±5.79)g/L],ALB[(37.79±3.94)g/L]and A/G(1.76±0.40)in the colonization group(P<0.05).ROC curve showed that the area under the curve was 0.981(0.964-0.998)of nine indeyes combined to differential diagnosis the Acinetobacter baumannii infection and colonization in patients with lower respiratory tract infection(LRTI)was the largest,with sensitivity of 95.70%,specificity of 92.90%,positive predictive value of 93.10%and negative predictive value of 95.60%.Conclusion The five common infection indexes combined with four serum protein indexes have better differential value for lower respiratory tract infection and colonization of Acinetobacter baumannii.
作者
刘海萍
韩蕾
王洪亮
杨新华
徐焰
杨妙迎
王妍
张丹红
LIU Haiping;HAN Lei;WANG Hongliang;YANG Xinhua;XU Yan;YANG Miaoying;WANG Yan;ZHANG Danhong(Department of Pathogenic Biology and Immunology,School of Basic Medical Sciences,Xi′an Jiaotong University,Xi′an,Shaanxi 710061,China;Department of Clinical Laboratory,Xi′an Daxing Hospital,Xi′an,Shaanxi 710016,China)
出处
《检验医学与临床》
CAS
2023年第2期145-149,共5页
Laboratory Medicine and Clinic
基金
国家自然科学基金资助项目(81702043)。
关键词
成人
下呼吸道感染
鲍曼不动杆菌
感染
定植
adult
lower respiratory tract infection
Acinetobacter baumannii
infection
colonization
作者简介
刘海萍,女,主管技师,主要从事临床微生物检验及细菌耐药机制研究;通信作者:韩蕾,E-mail:lei.han@xjtu.edu.cn。
