肺结核合并肺部感染患者病原菌分布及内毒素、钙结合蛋白检测的临床意义

目的 分析肺结核合并肺部感染患者病原菌分布及内毒素(LSP)、钙结合蛋白(S100A9)检测的临床意义.方法 选取2017年1月至2020年6月我院收治肺结核患者216例,根据有无合并肺部感染分为感染组与未感染组.分析肺结核患者肺部感染及病原菌分布情况,对比感染组与未感染组LSP、S100A9蛋白、降钙素原、C反应蛋白...

Distribution of pathogenic bacteria in patients with pulmonary tuberculosis and pulmonary infection and the clinical significance of LSP and S100A9 detection

Objective To analyze the distribution of pathogenic bacteria in patients with pulmonary tuberculosis and pulmonary infection and the clinical significance of detection of lipopolysaccharide(LSP)and calprotectin(S100A9).Methods We selected 216 patients with pulmonary tuberculosis admitted to our hospital from January 2017 to June 2020.According to whether the patients had pulmonary infection or not,they were divided into an infected group and a non-infected group.The pulmonary infection and the distribution of pathogenic bacteria in patients with pulmonary tuberculosis were analyzed.The levels of LSP,S100A9,procalcitonin(PCT),and C-reactive protein(CRP)were compared between the two groups.The risk factors leading to pulmonary infection were analyzed.The value of LSP and S100A9 detection in the diagnosis of pulmonary infection in patients was explored.Results Among the 216 patients,99 cases had pulmonary infection,and 117 had no pulmonary infection.We isolated 124 pathogenic bacteria from the sputum of the infected group.Of these,64 were gram-negative bacteria(51.61%),43 were gram-positive(34.68%),and 17 were fungi(13.71%).The levels of LSP,S100A9,PCT,and CRP in the infected group were higher than those in the non-infected group(P<0.05).There was no significant difference in gender,age,and disease course between the two groups(P>0.05).Abnormalities of PCT,CRP,LSP,and S100A9 were independent risk factors for pulmonary tuberculosis complicated with pulmonary infection(P<0.05).The AUC of ROC analysis for LSP and S100A9 in the diagnosis of pulmonary infection in the tuberculosis patients were 0.791 and 0.712,respectively.The AUC for LSP+S100A9 was 0.832,which was higher than that of single detection.The diagnostic value of LSP+S100A9 in the diagnosis of pulmonary tuberculosis complicated with pulmonary infection was higher than that of single diagnosis(P<0.05).Conclusion The pathogenic bacteria in tuberculosis patients with pulmonary infection are mainly gram-negative bacteria.The detection of LSP and S100A9 levels can lead to early diagnosis of pulmonary infection.The detection also has important reference value for assessing disease progression and choosing treatment options.