【摘要】 目的研究血浆(1,3)-β-D葡聚糖、C-反应蛋白(CRP)、中性粒细胞(NEU)百分比、白细胞计数(WBC)、血小板指标(PLT)及降钙素原(PCT)与真菌血流感染间的关系。方法本实验采用回顾性分析,选取2017年3月～2018年5月在我院住院治疗且血培养真菌指标阳性且被证实只有一种真菌感染的血流感染患者共计34例作为血流感染组,选取局部真菌感染患者34例作为局部感染组,另选取34例无真菌感染的患者作为对照组。根据检测真菌分型将血流感染组继分为白色念珠菌组及非白色念珠菌组。分析比较各组患者血浆(1,3)-β-D葡聚糖、CRP、NEU百分比、WBC、PLT及PCT间的统计学差异,并分析各指标同真菌性血流感染间的关系。结果真菌分型得出白色念珠菌组14例,非白色念珠菌组20例。血流感染组和真菌感染组血浆(1,3)-β-D葡聚糖、CRP、PLT、NEU百分比均高于对照组,差异有统计学意义(P <0.05);局部感染组血浆(1,3)-β-D葡聚糖及PLT水平均高于血流感染组,差异有统计学意义(P<0.05),两组其余指标间差异无统计学意义(P> 0.05);白色念珠菌组患者在血浆(1,3)-β-D葡聚糖、CRP、NEU百分比、WBC及PLT水平均高于对照组,差异有统计学意义(P <0.05),非白色念珠菌组患者血浆(1,3)-β-D葡聚糖、CRP、NEU百分比、WBC、PLT及PCT水平均高于对照组,差异有统计学意义(P <0.05),且非白色念珠菌组的PCT水平明显高于白色念珠菌组,差异有统计学意义(P <0.05)。结论血浆(1,3)-β-D葡聚糖、CRP、PLT、NEU百分比可反映是否存在真菌感染,而血浆(1,3)-β-D葡聚糖及PLT水平可反映血流感染的严重情况,PCT水平可以初步推断是否为非白色念珠菌感染或白色念珠菌感染。更多还原

【Abstract】 Objective To investigate the relationship between plasma(1,3)-β-D-glucan, C-reactive protein(CRP),percentage of neutrophil(NEU), white blood cell count(WBC), platelet index(PLT) and procalcitonin(PCT) and fungal bloodstream infection. Methods A retrospective analysis was conducted in this study. 34 patients with bloodstream infection who were hospitalized in our hospital from March 2017 to May 2018 and had positive indexes of fungi in blood culture and were confirmed to have only one fungal infection were recorded as bloodstream infection group, 34 patients with local fungal infection were selected as local infection group, and 34 patients without fungal infection were selected as control group. The bloodstream infection group was subdivided into Candida albicans group and nonCandida albicans group according to the fungal typing. Statistical differences of plasma(1,3)-β-D-glucan, CRP,NEU percentage, WBC, PLT and PCT in each group were analyzed and compared, and the relationship between each index and fungal bloodstream infection was analyzed. Results Fungus typing revealed 14 cases of Candida albicans group and 20 cases of non-Candida albicans group. Plasma(1,3)-β-D-glucan, CRP, PLT and NEU percentage in bloodstream infection group and local infection group were higher than the control group, with statistical significance(P< 0.05). The plasma(1,3)-β-D-glucan and PLT levels in the local infection group were higher than the bloodstream infection group(P < 0.05), there was no significant difference between the other indexes in the two groups(P > 0.05).Plasma(1,3)-β-D-glucan, CRP, NEU percentage, WBC and PLT levels in Candida albicans group were higher than the control group, with statistical significance(P < 0.05), the plasma(1,3)-β-D-glucan, CRP, NEU percentage,WBC and PLT levels in non-Candida albicans group were higher than the control group, with statistical significance(P< 0.05), and PCT levels in non-Candida albicans group was higher than the Candida albicans group, with statistical significance(P < 0.05). Conclusion Plasma(1,3)-β-D-glucan, CRP, PLT and NEU percentage can reflect the presence of fungal infection, while plasma(1,3)-β-D-glucan and PLT levels can reflect the severity of bloodstream infection. PCT levels can preliminarily infer whether there is non-Candida albicans infection or Candida albicans infection.更多还原