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中国防痨杂志 ›› 2013, Vol. 35 ›› Issue (9): 702-705.

• 论著 • 上一篇    下一篇

检测内毒素与C反应蛋白在诊断肺结核合并革兰阴性菌感染中的意义

李成行 李月翠   

  1. 321300  浙江省永康市第一人民医院感染科
  • 收稿日期:2013-05-16 出版日期:2013-09-10 发布日期:2013-09-08
  • 通信作者: 李成行 E-mail:lichenghang1984@163.com

Clinical value of endotoxin and C-reactive protein on the diagnosis of pulmonary tuberculosis patients with gram negative bacteria

LI Cheng-hang,LI Yue-cui   

  1. Department of Infectious Diseases,the First People Hospital of Yongkang, Yongkang,Zhejiang 321300,China
  • Received:2013-05-16 Online:2013-09-10 Published:2013-09-08
  • Contact: LI Cheng-hang E-mail:lichenghang1984@163.com

摘要: 目的  研究肺结核合并革兰阴性菌(Gram negative bacilli,G)感染的患者检测血浆内毒素及C反应蛋白(C-reactive protein,CRP)含量的临床意义。 方法  采用回顾性调查研究,根据240例肺结核患者全血细菌培养及痰细菌培养的G菌生长情况,将患者分为G菌生长组、革兰阳性菌(G菌)(包括真菌)生长组及无细菌生长组。比较分析各组患者的血浆内毒素及CRP定量水平差异。 结果 G菌生长组内毒素(317.34 pg/ml)、CRP水平(65.43 mg/L)高于G菌(包括真菌)生长组(内毒素为34.78 pg/ml,CRP水平35.33 mg/L),差异有统计学意义(Z=-1.793,Z=-1.106,P值均<0.05);G菌生长组内毒素、CRP水平高于无细菌生长组(内毒素为20.06 pg/ml,CRP水平15.34 mg/L),差异有显著统计学意义(Z=-2.397,Z=-1.950;P值均<0.01)。G菌生长组内毒素变化与CRP的升高具有相关性(r=0.458,P<0.05)。 结论  检测血浆内毒素及CRP含量有助于快速判断肺结核患者是否合并革兰阴性菌感染,有利于临床合理用药、及时对症治疗。

关键词: 结核, 肺/并发症, 革兰阴性菌感染, 内毒素类, C反应蛋白质

Abstract: Objective To explore the clinical value of endotoxin and C-reactive protein (CRP) on tuberculosis (TB) patients with gram negative bacteria. Methods Two hundred and fourty TB inpatients were analyzed by retrospective investigation. According to the results of sputum culture and hemoculture, the patients were divided into gram-negative bacterium group, gram-positive bacterium group and culture-negative group. The concentrations of endotoxin and the levels of CRP in plasma from these patients were analyzed. Results The concentrations of endotoxin (317.34 pg/ml) and the levels of CRP (65.43 mg/L) in gram-negative bacterium group were significantly higher than that in gram-positive bacterium group (34.78 pg/ml, 35.33 mg/L) (Z=-1.793, Z=-1.106, P<0.05), and those in gram-negative bacterium group were significantly higher than that in culture-negative group (20.06 pg/ml, 15.34 mg/L) (Z=-2.397, Z=-1.950, P<0.01); There was correlation between endotoxin and CRP in gram-negative bacterium group (r=0.458, P<0.05). Conclusion The detection of endotoxin and CRP in TB patients will help to rapidly indentify gram-negative bacterium infection, improving the accuracy of clinical diagnosis and making reasonable prescription.

Key words: Tuberculosis, pulmonary/complications, Gram-negative bacterial infections, Endotoxins, C-Reactive protein