多重PCR法及粪乳铁蛋白检测在急性腹泻患者诊断中的运用

摘要

目的：探讨多重PCR法及粪便乳铁蛋白在诊断急性腹泻伴脱水患者中的临床价值。方法选取2015年1月～12月于我院急诊科就诊患者共59例，其中包括轻度脱水患者29例，中到重度脱水患者30例。两组患者都进行血常规（白细胞计数）、CRP、粪白细胞镜检、粪乳铁蛋白等检测，病原学检查包括传统粪便培养及多重PCR。结果在轻度脱水患者中多重PCR法病原体检出率为79.31%（23/29），传统粪培养检出率为24.13%（7/29）。在中到重度脱水患者中，多重PCR法病原体检出率为73.33%（22/30），传统粪培养检出率为30.00%（9/30），在两组患者中，多重PCR法病原检出率均大于传统粪培养检出率，差异具统计学意义（P＜0.05）。轻度脱水患者粪乳铁蛋白检出率为44.82%（13/29），中到重度脱水患者粪乳铁蛋白检出率为76.67%（23/30），中到重度脱水患者粪乳铁蛋白检出率大于轻度脱水患者，差异具统计学意义（P＜0.05）。结论在腹泻所致脱水患者中，多重PCR法在病原学的检出率上优于传统法。粪乳铁蛋白检测对腹泻患者脱水情况的判断有一定临床价值。%Objective To investigate the clinical value of multiple PCR method and fecal lactoferrin in diagnosis of patients with dehydration in acute diarrhea. Methods59 patients visited the emergency department from January 2015 to December were randomly selected and divided into two groups,which included 29 patients in mild dehydration group,and 30 patients in moderate to severe dehydration group.All the patients in the two groups were treated with routine blood (white blood cells count),CRP and fecal lactoferrin detection.Etiological examination included traditional stool culture and multiplex PCR.Results The etiological detection rate of PCR method in mild dehydration group was 79.31%(23/29),which was 24.13%(7/29) with traditional method.In the moderate to severe dehydration group,the etiological detection rate of PCR method was 73.33%(22/30),which was 30.00%(9/30) with traditional method.In both groups,etiological detection rate was higher when using multiple PCR method compared to the traditional fecal culture,the results were statistically significant(P<0.05).The fecal lactoferrin detection rate was 44.82%(13/29) in patients with mild dehydration,which was 76.67%(23/30) in patients with moderate to severe dehydration.The detection rate of fecal lactoferrin in moderate to severe dehydration group was higher than mild dehydration group,the results were statistically significant(P<0.05).Conclusion In patients with acute diarrhea dehydration,PCR method is superior to the traditional method in the detection rate of pathogens.There is a certain clinical value of fecal lactoferrin on the judgment of patients with dehydration.