标题：支气管哮喘合并肺部感染患者PCT、炎症指标检测及其病原菌分析

      作者：郭方 1，郭红 2，蔡玮 2，陈岗 2    1.陕西省友谊医院检验科，陕西 西安 710068；2.陕西省杨凌示范区医院检验科，陕西 咸阳 712100

      卷次： 2019年30卷18期

      【摘要】 目的 研究支气管哮喘合并肺部感染患者血清降钙素原(PCT)、炎症指标水平及病原菌分布状况，为患者的临床诊断提供指导。方法 选取2018年1月至2019年3月期间陕西省友谊医院接诊的支气管哮喘合并肺部感染患者50例作为观察组，同时间段未发生肺部感染的支气管哮喘患者50例作为对照组。患者入组后，比较两组患者PCT、超敏C反应蛋白(hs-CRP)和白细胞介素-6 (IL-6)水平，并检测观察组患者的病原菌分布及耐药情况。结果 观察组患者血清中PCT，hs-CRP和IL-6含量分别为(22.82±3.51) pg/mL、(0.71±0.19) mg/L和(57.92±3.22) pg/mL，均明显高于对照组的(14.71±2.63) pg/mL、(0.44±0.12) mg/L和(33.44±3.14) pg/mL，差异均有统计学意义(P<0.05)；观察组患者中共检出103株病原菌，其中革兰氏阳性菌共37株，占35.92%，主要是肺炎链球菌；革兰氏阴性菌共61株占59.22%，主要是流感嗜血杆菌；真菌共5株，占4.85%；革兰氏阳性菌中金黄色葡萄球菌和化脓性链球菌对美罗培南和青霉素比较敏感，金黄色葡萄球菌，化脓性链球菌和肺炎链球菌对头孢拉定和头孢唑林的耐药率都超过了50%；革兰氏阴性菌中铜绿假单胞菌和肺炎克雷伯菌对亚胺培南比较敏感，流感嗜血杆菌对美罗培南比较敏感。铜绿假单胞菌、肺炎克雷伯菌和流感嗜血杆菌对头孢噻吩和替考拉宁的耐药率都超过50%。结论 支气管哮喘合并肺部感染患者的血清PCT和炎症因子水平明显升高，检测病原菌有助于患者的临床诊断。
      【关键词】 支气管哮喘；肺部感染；血清降钙素原；炎症指标；病原菌
      【中图分类号】 R562.2+5 【文献标识码】 A 【文章编号】 1003—6350（2019）18—2341—04

Detection of PCT, inflammatory index and analysis of pathogenic bacteria in patients with bronchial asthma andpulmonary infection.
GUO Fang 1, GUO Hong 2, CAI Wei 2, CHEN Gang 2. 1. Department of Clinical Laboratory, theFriendship Hospital of Shaanxi Province, Xi'an 710068, Shaanxi, CHINA; 2. Department of Clinical Laboratory, theYangling Demonstration Area Hospital of Shaanxi Province, Xianyang 712100, Shaanxi, CHINA
【Abstract】 Objective To study the procalcitonin (PCT), inflammation index and pathogenic profile in patientswith bronchial asthma complicated with pulmonary infection, and provide certain value for the detection of clinical indi-cators. Methods A total of 50 patients with bronchial asthma complicated with pulmonary infection who were treatedin the Friendship Hospital of Shaanxi Province from January 2018 to March 2019 were selected as the experimental group.During the same period, 50 patients with no pulmonary infection were enrolled into the control group. After grouping, thelevels of serum procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP), and interleukin-6 (IL-6), the distributionof pathogens, and pathogen resistance were detected and compared between the two groups. Results The serum PCT,hs-CRP, IL-6 levels of the experimental group were (22.82±3.51) pg/mL, (0.71±0.19) mg/L, (57.92±3.22) pg/mL, respec-tively, which were significantly higher than corresponding (14.71±2.63) pg/mL, (0.44±0.12) mg/L, (33.44±3.14) pg/mL ofthe control group (all P<0.05). A total of 103 pathogens were detected in the experimental group, including 37 strains ofGram-positive bacteria (accounting for 35.92%, mainly Streptococcus pneumonia), 61 strains of Gram-negative bacteria(accounting for 59.22%, mainly Haemophilus influenza), 5 strains of fungi (accounting for 4.85%). Gram-positive bacte-ria in Staphylococcus aureus and Streptococcus pyogenes were sensitive to meropenem and penicillin. The resistant ratesof Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus pneumoniae to cefradine and cefazolin were more than