慢阻肺患者急性加重期病原菌分布及其降钙素原水平分析

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者的病原菌分布及其降钙素原(PCT)水平,以期为AECOPD的抗菌治疗提供更多的理论依据。方法以2014年10月-2015年9月在我科住院的129例AECOPD患者为研究对象,所有AECOPD患者入院时即刻采血测血清PCT,留痰行病原学检查,并对相关测定结果进行统计学分析。结果 129例患者痰液标本阳性69例,阳性率为53.48%,其中革兰阴性菌(G~-)43例,占62.32%,革兰阳性菌(G~+)26例,占37.68%,首位是流感嗜血杆菌(17.39%),对应PCT为0.64(0.41-1.50)。G~-感染组血清PCT水平较G~+组明显升高(Z=-6.447,P0.05)。随着血清PCT水平的升高,痰液细菌培养阳性率也相应升高(χ~2=18.94,P0.05)。结论 AECOPD患者以流感嗜血杆菌、肺炎克雷伯菌的G-菌感染为主,且G~-菌感染者血清PCT水平显著升高。临床上应在细菌培养和PCT指导下合理用药。

Analysis of bacterial distribution and procalcitonin in patients with AECOPD

Objective To investigate the bacterial distribution and procalcitonin ( PCT ) level in patients with AECOPD, in order to provide more theoretical basis for antimicrobial therapy of AECOPD patients. Methods 129 patients with AECOPD from October 2014 to September 2015 were selected as the research object, and all the patients were taken blood collection to detect serum PCT. Sputum etiology examination was performed by sputum specimens, and the relative determination Results were statistically analyzed. Results In the 129 strains, the ger-miculture positive rate was 53. 48%, including 62. 32% of G-, and 37. 68% of G+ bacteria. The first rank was hae-mophilus influenzae ( 17. 39%) , with the level of PCT 0. 64 ( 0. 41 -1. 50 ) . The level of serum PCT in the G-group was significantly higher than that in the G+ group (Z= -6. 447, P<0. 05). With the increase of serum PCT, germiculture positive rate also increased (χ2 =18. 94, P <0. 05). Conclusion The main bacteria in AECOPD group include haemophilus influenza and G- Klebsiella pneumoniae, and the level of serum PCT is significantly high-er in G- positive patients. The rational use of drugs should be strictly under the guidance of bacteria culture and PCT.