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目的探讨早期联合各类炎症指标对于鉴别不同病原菌血流感染的价值。方法收集2011年1月-2015年12月本院血培养阳性患者152例为血培养阳性组,根据血培养结果分为革兰阴性菌组、革兰阳性菌组及真菌组,同时收集50例血培养结果阴性者作为对照组,记录入院后第1 d的炎症相关实验室指标结果,用Logistic回归分析探讨不同病原菌血流感染的鉴别指标。结果血培养阳性组共152例,其中革兰阴性菌占50.0%(76/152),革兰阳性菌占46.1%(70/152),真菌占3.9%(6/152);3组间CRP、PCT、NLR、PLR、RDW、ESR及PA/Fig的差异有统计学意义(P均<0.05)。革兰阴性菌组NLR与PA/Fig差异有统计学意义(P<0.05)[OR及95%CI分别为:1.119(1.019~1.229);0.563(0.360~0.880)];革兰阳性菌组PLR及ESR差异有统计学意义(P<0.05)[OR及95%CI分别为:1.078(1.053~1.128)、1.022(1.001~1.043)];真菌组RDW值差异有统计学意义(P<0.05)[OR及95%CI:1.292(1.039~1.607)]。结论 NLR及PA/Fig可鉴别革兰阴性菌血流感染,PLR及ESR可鉴别革兰阳性菌血流感染,RDW值可鉴别真菌血流感染。
Objective To explore the early combination of various inflammatory markers for the identification of different pathogens bloodstream infection value. Methods From January 2011 to December 2015, 152 blood-positive patients in our hospital were positive for blood culture. According to the results of blood culture, Gram-negative bacteria, Gram-positive bacteria and fungi were collected. Fifty Blood culture negative results as a control group, record 1 d after admission on the index of inflammation-related laboratory results using Logistic regression analysis of different pathogens bloodstream infection in the identification of indicators. Results A total of 152 patients were positive for blood culture, of which Gram-negative bacteria accounted for 50.0% (76/152), Gram-positive bacteria accounted for 46.1% (70/152) and fungi accounted for 3.9% (6/152) , PCT, NLR, PLR, RDW, ESR and PA / Fig were significantly different (all P <0.05). Gram-negative bacteria group NLR and PA / Fig difference was statistically significant (P <0.05), OR and 95% CI were 1.119 (1.019 ~ 1.229), 0.563 (0.360 ~ 0.880) (P <0.05). There was a significant difference in RDW between fungal group and control group (P <0.05) [OR and 95% CI: 1.292 (1.039 ~ 1.607)]. Conclusion NLR and PA / Fig can identify Gram-negative bloodstream infections, PLR and ESR can identify Gram-positive bloodstream infections, RDW value can identify fungal bloodstream infections.