血浆内毒素及(1-3)-β-D葡聚糖测定在急性胰腺炎感染中的应用价值

摘要

Objective To investigate the clinical application value of endotoxin and (1-3)-β-D glucan detection in the patients with acute pancreatitis(AP).Methods The MB-80 microbiology rapid dynamic detection system was applied to detect the concentration of plasma LPS and (1-3)-β-D glucan in the patients with AP.Then the results were analyzed.Results Among 184 cases of AP complicating peripancreatic abscess and bilateral lung infection,endotoxin G-lipopolysaccharides positive was in 23 cases,the average value was 394.07 pg/mL,the positive rate was 10.87%,and 15 cases of Gram-negative bacterial infection were verified by the microorganism culture.Among 175 cases of AP complicating peripancreatic abscess and bilateral lung infection,67 cases were(1-3)-β-D glucan positive,the average value was 93.22 pg/mL,the positive rate was 38.29%,which were with the positive rate of serum(1-3)-β-D glucan in the non-AP group,the difference was statistically significant(P<0.05),the microorganism culture or smear verified that 22 cases were fungal infection.Conclusion Plasma endotoxin and (1-3)-β-D glucan detection provides the laboratory biological indicator and is conducive to the assessment of AP infection severity and clinical medication.%目的 研究急性胰腺炎(AP)患者血液中内毒素、(1-3)-β-D葡聚糖浓度检测的临床应用价值.方法 采用MB-80微生物快速动态检系统检测AP患者血浆中的内毒素和(1-3)-β-D葡聚糖浓度,并进行分析.结果 184例AP合并胰腺周围脓肿和双肺感染等的患者,内毒素(G-脂多糖)测定阳性者23例,平均值为93.22 pg/mL,阳性率为10.87%,经微生物培养证实其中15例为革兰阴性菌感染.175例AP合并胰腺周围脓肿和双肺感染等的患者中,检出67例(1-3)-β-D葡聚糖阳性,平均值为394.07 pg/mL,阳性率为38.29%,与非AP患者组血清(1-3)-β-D葡聚糖阳性率比较,差异有统计学意义(P<0.05),经微生物培养或涂片,证实其中22例为真菌感染.结论 血浆内毒素、(1-3)-β-D葡聚糖定量测定,为早期AP全身感染预测提供了实验室生物学指标,有助于AP感染严重程度评估和临床合理用药.