Significance of pathogen detection in patients with ventilator-associated pneumonia and changes of PCT,CRP and pulmonary function / 国际检验医学杂志

ABSTRACT

Objective To investigate the pathogenic characteristics of patients with ventilator associated pneumonia ,and analyze the correlation with the changes of serum procalcitonin (PCT ) ,C reactive protein (CRP) and pulmonary function .Methods 110 cases of patients with ventilator associated pneumonia was selected in a hospital from October 2014 to October 2016 as pathogenic groups .At the same time ,patients treated with ventilator adjuvant therapy for the same period without infection as non-pathogenic group (120 cases) ,selecting the same period of physical examination no abnormal patients as the healthy group (95 cases) ,detection and analysis of pathogenic characteristics in patients with ventilator associated pneumonia , detection of the serum levels of PCT ,CRP and lung function .Analyzed the correlation with the changes of ser-um PCT ,CRP and pulmonary function .Results 210 strains of pathogens were isolated from the secretions of 110 patients with pathogenic groups ,among them ,90 strains of Gram-positive bacteria accounted for 42 .85%, Gram-type negative bacteria accounted for 119 cases accounted for 56 .67% and a strain of fungus .The levels of PCT and CRP in the non-pathogenic group and pathogenic group were significantly higher than those in the healthy group ,the difference was statistically significant (P＜0 .05) .Serum PCT and CRP levels in the patho-genic group were significantly higher than those in the non-pathogenic group and the healthy group ,the differ- ence was statistically significant (P＜0 .05) .Logistic multiple regression analysis was used to analyze the inde-pendent risk factors of ventilator-associated pneumonia in patients .The duration of invasive ventilation ,gram-negative oropharyngeal bacteria count ,age and past history of COPD were independent risk factors ,with sig-nificant difference (P＜0 .05) .Patients in the pathogenic group had a forced expiratory volume (FEV1) ,forced vital capacity (FVC) ,forced expiratory force occupancy force ratio (FEV1/FVC) ,the first second percentage of forced vital capacity occupies vital capacity (FEV1%)were significantly higher than those in the non-patho-genic group and the healthy group ,the difference was statistically significant (P＜0 .05) .FEV1 ,FVC ,FEV1/FVC and FEV1% in the non-pathogenic group and pathogenic group were significantly higher than those in the healthy group ,the difference was statistically significant (P＜0 .05) .Conclusion Gram-negative bacteria predominate in ventilator-associated pneumonia .