摘要
目的研究中性粒细胞膜碱性磷酸酶(mNAP)表达在全身炎症反应综合征(SIRS)患者血流细菌感染诊断中的应用价值。方法 138例SIRS患者依据血培养结果分组:SIRS血培养阳性组55例(其中革兰氏阴性菌感染39例,革兰氏阳性菌感染16例)、SIRS血培养阴性组83例(局部感染41例,非感染42例)。应用流式细胞技术定量检测mNAP,散射免疫比浊法测定C-反应蛋白(CRP),电化学发光法测定降钙素原(PCT);比较mNAP与CRP、PCT的相关性,并分析它们对SIRS患者血流细菌感染的预测价值。结果 SIRS血培养阳性组mNAP、CRP、PCT均显著高于SIRS血培养阴性组(Z=10.133、4.555、9.130,P<0.05),对血流感染的诊断特异性和敏感性分别是97.1%和96.0%,阴性、阳性预测率分别是94.1%和97.9%,均明显高于CRP和PCT。革兰氏阴性菌感染患者mNAP水平明显高于革兰氏阳性菌感染患者(Z=3.279,P<0.05)。结论采用流式细胞技术定量测定mNAP是可行的,并首次将其应用于SIRS患者的血流细菌感染的预测,灵敏度高、特异性好,临床应用前景广阔。
Objective To study the application value of alkaline phosphatase on the neutrophils membrane surface（m NAP） expression in the diagnosis of bloodstream infections in patients with systemic inflammatory response syndrome（SIRS）. Methods According to the results of blood culture group, 138 cases of SIRS patients were divided into： SIRS blood culture positive group（55 cases）, including 39 cases of gram-negative bacterium infection, 16 cases of gram-positive bacteria infection; SIRS blood culture negative group（83 cases）, including 41 cases of local infection, 42 cases of non-infection）. Application of flow cytometry technology quantitative detection of m NAP, scattering immune turbidimetric method for the determination of C-reactive protein（CRP）, electrochemical luminescence spectrometry determination of calcitonin original（PCT）. Results The level of m NAP, CRP and PCT in blood culture positive group were significantly higher than blood culture negative groups（Z=10.133, 4.555, 9.130, P〈0.05）. Specificity and sensitivity of m NAP to the diagnosis of blood stream infection were 97.1% and 96.0%, respectively, the negative and positive predictive rate were 94.1% and 97.9%, respectively, were significantly higher than that of PCT and CRP. m NAP level of gram-negative bacteria infection was significantly higher in patients with gram positive bacteria infection（Z=3.279, P〈 0.279） in patients. Conclusion The quantitative determination of m NAP by flow cytometry technique is feasible, and the first time applied to predict bloodstream infections in patients with SIRS.Its high sensitivity, good specificity, have a prospect clinical application.
出处
《中国医药科学》
2016年第19期171-174,共4页
China Medicine And Pharmacy
关键词
全身炎症反应综合征
细菌感染
中性粒细胞膜碱性磷酸酶
C-反应蛋白
降钙素原
Systemic inflammatory response syndrome
Bloodstream infections
Alkaline phosphatase on the neutrophils membrane surface
C-reactive protein
Calcitonin
