[1]秦　云.肺炎患者血液PLT，PA/Fig和NGAL联合检测在不同类型病原菌感染鉴别及疗效评估中的价值[J].现代检验医学杂志,2021,36(05):83-89.[doi:10.3969/j.issn.1671-7414.2021.05.019]
　QIN Yun.Value of Combined Detection of PLT, PA/Fig and NGAL in the Blood ofPatients with Pneumonia in the Identification of Different Types ofPathogenic Infections and the Evaluation of Therapeutic Effects[J].Journal of Modern Laboratory Medicine,2021,36(05):83-89.[doi:10.3969/j.issn.1671-7414.2021.05.019]
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肺炎患者血液PLT，PA/Fig和NGAL联合检测在不同类型病原菌感染鉴别及疗效评估中的价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年05期
页码:
83-89
栏目:
论　著
出版日期:
2021-10-14

文章信息/Info

Title:
Value of Combined Detection of PLT, PA/Fig and NGAL in the Blood ofPatients with Pneumonia in the Identification of Different Types ofPathogenic Infections and the Evaluation of Therapeutic Effects
文章编号:
1671-7414（2021）05-083-07
作者:
秦　云
( 上海交通大学医学院附属新华医院崇明分院检验科，上海 202150)
Author(s):
QIN Yun
（Department of Laboratory Medicine, Chongming Branch, Xinhua Hospital, School of Medicine,Shanghai Jiaotong University, Shanghai 202150, China）
关键词:
肺炎; 革兰阴性菌; 革兰阳性菌; 真菌; 血小板; 前清蛋白纤维蛋白原比值; 中性粒细胞明胶酶相关脂质运载蛋白
分类号:
R563.1；R446.112
DOI:
10.3969/j.issn.1671-7414.2021.05.019
文献标志码:
A
摘要:
目的　探讨肺炎患者血液血小板（PLT），前清蛋白纤维蛋白原比值（PA/Fig）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）联合检测在不同类型病原菌感染鉴别及疗效评估中的价值。方法　选取2018年1月～2020年4月上海交通大学医学院附属新华医院崇明分院收治的52例革兰阴性菌感染肺炎患者（革兰阴性菌组）、52例革兰阳性菌感染肺炎患者（革兰阳性菌组）和52例真菌感染肺炎患者（真菌组），血培养或其生理无菌部位标本培养结果阳性，同期选取52例健康体检者（对照组），比较各组PLT，PA/Fig，NGAL和临床肺部感染（CPIS）评分，采用受试者工作特征曲线（ROC）及ROC下面积（AUC）分析PLT，PA/Fig，NGAL鉴别不同病原菌的效能，采用Pearson分析各组PLT，PA/Fig，NGAL与CPIS评分相关性，并比较不同疗效患者PLT，PA/Fig，NGAL，采用ROC与AUC分析PLT，PA/Fig和NGAL预测无效的效能。结果　PLT：革兰阴性菌组[（116.59±24.61）×109/L]＜革兰阳性菌组[（146.97±26.52）×109/L]＜真菌组[（170.50±22.89）×109/L]＜对照组[（220.18±25.39）×109/L]。PA/Fig：革兰阳性菌组（3.41±1.36）＜革兰阴性菌组（5.68±1.20）＜真菌组（7.97±1.21）＜对照组（9.88±1.05）。NGAL：真菌组（129.87±48.25pg/ml）＜对照组（162.01±21.39pg/ml）＜革兰阴性菌组（302.49±50.88pg/ml）＜革兰阳性菌组（368.44±54.67pg/ml），差异有统计学意义（F1=160.502，P1＜0.001；F2=279.229，P2＜0.001；F3=320.096，P3＜0.001）。PLT，PA/Fig和NGAL鉴别革兰阳性菌、革兰阴性菌、真菌的AUC值均较高；革兰阳性菌、革兰阴性菌和真菌感染患者PLT，PA/Fig，NGAL均与CPIS评分相关；有效患者[PLT（153.97±20.47）×109/L，PA/Fig（6.18±1.06）]高于无效患者[（93.65±22.38）×109/L，3.00±0.97]，差异有统计学意义（t=13.090，11.565，均P＜0.05）；PLT+PA/Fig预测无效的AUC为0.862，高于单一预测（0.808，0.778）。结论　PLT，PA/Fig和NGAL可用于肺炎不同病原菌鉴别及病情评估，且PLT，PA/Fig和NGAL在预测疗效方面具有较高应用价值，可为临床诊治提供一定依据。
Abstract:
Objective　To explore the value of platelet (PLT), prealbu-min/fibrinogen (PA/Fig) and neutrophil gelatinaseassociatedlipocalin (NGAL) combined detection in patients with pneumonia in the identification and efficacy evaluation ofdifferent types of pathogenic infections. Methods　From January 2018 to April 2020, 52 cases of pneumonia patients caused byGram-negative bacteria (Gram-negative bacteria group), 52 patients with pneumonia caused by Gram-positive bacteria (Grampositivebacteria group), and 52 patients with pneumonia caused by fungal infection (fungal group) were selected in ChongmingBranch of Xinhua Hospital, School of Medicine, Shanghai Jiaotong University. The results of blood culture or specimens ofphysiologically sterile parts were positive, and 52 healthy persons (control group) were selected during the same period. The PLT,PA/Fig, NGAL and clinical pulmonary infection score (CPIS) of each group were compared. The receiver operating characteristiccurve (ROC) and the area under the ROC (AUC) were used to analyze the efficacy of PLT, PA/Fig and NGAL in identifyingdifferent pathogens. Pearson was used to analyze the correlation between PLT, PA/Fig, NGAL and CPIS scores in each group.The PLT, PA/Fig and NGAL of patients with different curative effects were compared. ROC and AUC were used to analyze theefficacy of PLT, PA/Fig and NGAL in predicting ineffectiveness. Results　PLT: Gram-negative bacteria group [(116.59±24.61)×109/L] ＜ Gram-positive bacteria group [(146.97±26.52)×109/L] ＜ fungi group [(170.50±22.89)×109/L]＜ control group [(220.18±25.39)×109/L], PA/Fig: Gram-positive bacteria group (3.41±1.36) ＜ Gram-negative bacteria group(5.68±1.20) ＜ fungi group (7.97±1.21) ＜ control group (9.88±1.05). NGAL: fungus group (129.87±48.25 pg/ml) ＜ controlgroup (162.01±21.39 pg/ml) ＜ Gram-negative bacteria group (302.49±50.88 pg/ml) ＜ Gram-positive bacteria group(368.44±54.67 pg/ml), the difference was statistically significant (F1=160.502, P1 ＜ 0.001; F2=279.229, P2 ＜ 0.001;F3=320.096, P3 ＜ 0.001). The AUC values of PLT, PA/Fig and NGAL were higher in identifying Gram-positive bacteria, Gramnegativebacteria and fungi. PLT, PA/Fig and NGAL in patients with Gram-positive bacteria, Gram-negative bacteria, and fungalinfections were all related to CPIS score. PLT [(153.97±20.47)×109/L] and PA/Fig (6.18±1.06) of effective patients werehigher than those of invalid patients [(93.65±22.38)×109/L, 3.00±0.97], and the difference was statistically significant(t=13.090,11.565, all P ＜ 0.05). The AUC of PLT + PA/Fig was 0.862, which was higher than that of single prediction (0.808,0.778). Conclusion　PLT, PA/Fign and NGAL can be used for the identification of different pathogens of pneumonia and diseaseevaluation, and PLT, PA/Fig and NGAL have high application value in predicting curative effect, and can provide certain basis forclinical diagnosis and treatment.

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备注/Memo

备注/Memo:
作者简介：秦云（1973-），女，本科，主管技师，研究方向：微生物检验，E-mail:qiny121212@sina.com。
更新日期/Last Update: 1900-01-01