血浆脂多糖浓度检测对器官移植患者革兰阴性细菌感染的诊断价值

doi:10.3969/j.issn.1673-8640.2015.08.005

检验医学 ›› 2015, Vol. 30 ›› Issue (8): 794-797.DOI: 10.3969/j.issn.1673-8640.2015.08.005

血浆脂多糖浓度检测对器官移植患者革兰阴性细菌感染的诊断价值

唐晴琴, 胡志德, 刘耀婷, 杨敏, 魏婷婷, 马宁, 秦保东, 傅海涛, 仲人前

第二军医大学附属长征医院实验诊断科,上海 200003

收稿日期:2014-10-27 出版日期:2015-08-30 发布日期:2015-08-28
作者简介:null
作者简介:唐晴琴,女,1989年生,硕士,主要从事感染免疫研究。

通讯作者:仲人前,联系电话:021-81886092。
基金资助:
国家重点基础研究发展计划项目(2013CB531603)

The diagnosis significance of plasma lipopolysaccharide determination for Gram-negative bacterium infection in organ transplantation recipients

TANG Qingqin, HU Zhide, LIU Yaoting, YANG Min, WEI Tingting, MA Ning, QIN Baodong, FU Haitao, ZHONG Renqian.

Department of Laboratory Diagnosis, Changzheng Hospital, the Second Military Medical University, Shanghai 200003,China

Received:2014-10-27 Online:2015-08-30 Published:2015-08-28

摘要/Abstract

摘要：

目的探讨血浆脂多糖(LPS)浓度检测对器官移植患者革兰阴性细菌(GNB)感染的诊断价值。方法回顾性分析160例疑似感染的器官移植患者的病史,根据细菌分离培养的结果将患者分为GNB感染组和对照组。采用动态比浊法检测患者就诊时外周血LPS浓度。以受试者工作特征(ROC)曲线评价LPS浓度检测对GNB感染的诊断价值。结果 GNB感染组和对照组LPS浓度的中位数(四分位数)分别为33.58(22.12,73.59)和5.00(5.00,9.78)pg/mL,两者差异有统计学意义(P<0.05)。LPS浓度检测诊断GNB感染的ROC曲线下面积为0.834(95%可信区间0.764~0.903)。当诊断界值设定为20 pg/mL时,LPS浓度检测诊断GNB感染的敏感性为81.01%,特异性为88.89%。结论在器官移植患者中,LPS是诊断GNB感染的有效生物标志物。

关键词: 脂多糖, 革兰阴性细菌, 器官移植, 诊断

Abstract:

Objective To evaluate the diagnosis significance of plasma lipopolysaccharide (LPS) determination for Gram-negative bacterium (GNB) infection in organ transplantation recipients. Methods The clinical data of 160 liver transplantation and kidney transplantation patients were analyzed retrospectively. According to the results of bacterium isolation culturing, there were 2 groups, GNB group and control group. The LPS concentrations were determined by dynamic turbidimetric assay. Receiver operating characteristic (ROC) curve was used to analyze the diagnosis significance of LPS for GNB infection. Results LPS in GNB group was 33.58(22.12, 73.59)pg/mL, while it in control group was 5.00(5.00,9.78)pg/mL. The difference was statistically significant (P<0.05). The area under ROC curve was 0.834 (95% confidence interval 0.764-0.903). The LPS determination sensitivity and specificity were 81.01% and 88.89%, respectively, at the cut-off value of 20 pg/mL. Conclusions LPS is an effective diagnosis biomarker for GNB infection in organ transplantation recipients.

Key words: Lipopolysaccharide, Gram-negative bacterium, Organ transplantation, Diagnosis

中图分类号:

R446.62

唐晴琴, 胡志德, 刘耀婷, 杨敏, 魏婷婷, 马宁, 秦保东, 傅海涛, 仲人前. 血浆脂多糖浓度检测对器官移植患者革兰阴性细菌感染的诊断价值[J]. 检验医学, 2015, 30(8): 794-797.

TANG Qingqin, HU Zhide, LIU Yaoting, YANG Min, WEI Tingting, MA Ning, QIN Baodong, FU Haitao, ZHONG Renqian.. The diagnosis significance of plasma lipopolysaccharide determination for Gram-negative bacterium infection in organ transplantation recipients[J]. Laboratory Medicine, 2015, 30(8): 794-797.

图/表 4

参考文献 16

[1]	LEE SG.Current status of liver transplantation in Korea[J]. Korean J Gastroenterol, 2005, 46(2):75-83.
[2]	SHEPHERD RW, TURMELLE Y, NADLER M, et al.Risk factors for rejection and infection in pediatric liver transplantation[J].Am J Transplant,2008,8(2):396-403.
[3]	SINGH N, WAGENER MM, OBMAN A, et al.Bacteremias in liver trasplant recipients: shift toward gram-negative bacteria as predominant pathogens[J].Liver Transpl, 2004, 10(7):844-849.
[4]	SHI SH, KONG HS, XU J, et al.Multidrug resistant gram-negative bacilli as predominant bacteremic pathogens in liver transplant recipients[J]. Transpl Infect Dis,2009, 11(5):405-412.
[5]	SHI SH, KONG HS, JIA CK, et al.Risk factors for pneumonia caused by multidrug-resistant Gram-negative bacilli among liver recipients[J]. Clin Transplant,2010, 24(6):758-765.
[6]	董海新, 曹震. 脂多糖检测对疾病的诊断和治疗的意义[J]. 医学检验与临床,2010, 21(5): 100-101.
[7]	魏谋, 唐娟, 林惠海,等. 格兰阴性菌感染新生儿血浆脂多糖测定临床意义[J]. 中华实用诊断与治疗杂志,2013, 27(6): 623-624.
[8]	周碧燕, 李友邕, 覃李线,等. 血浆(1-3)-β-D-葡聚糖及内毒素检测在重症监护病人早期感染诊断中的应用[J]. 中国卫生检验杂志,2011, 21(7): 1737-1739.
[9]	时勇. 血浆脂多糖检测快速诊断格兰阴性菌感染的研究[J]. 国际检验医学杂志,2013, 34(12): 1563-1564.
[10]	CHORDIA P, SCHAIN D, KAYLER L.Effects of ureteral stents on risk of bacteriuria in renal allograft recipients[J]. Transpl Infect Dis,2013, 15(3): 268-275.
[11]	SANTORO-LOPES G, DE GOUVÊA EF. Multidrug-resistant bacterial infections after liver transplantation: an ever-growing challenge[J].World J Gastroenterol,2014, 20(20): 6201-6210.
[12]	VAN DELDEN C, BLUMBERG EA, AST Infectious Diseases Community of Practice. Multidrug resistant gram-negative bacteria in solid organ transplant recipients[J]. Am J Transplant, 2009, 9(Suppl 4):S27-S34.
[13]	KIM SI, KIM YJ, JUN YH, et al.Epidemiology and risk factors for bacteremia in 144 consecutive living-donor liver transplant recipients[J]. Yonsei Med J,2009, 50(1):112-121.
[14]	郭澄,张剑萍,华雪蔚,等. 从处方分析探讨“全国抗菌药物临床应用专项整治活动”的必要性[J].中国药房,2012,2(23):97-101.
[15]	LAXMINARAYAN R, DUSE A, WATTAL C, et al.Antibiotic resistance-the need for global solutions[J]. Lancet Infect Dis, 2014, 12(13):1057-1078.
[16]	BÖLKE E, JEHLE PM, ORTH K, et al. Changes of gut barrier function during anesthesia and cardiac surgery[J]. Angiology, 2001, 52(7): 477-482.

组别	例数	LPS[P₅₀(P₂₅, P₇₅),pg/mL]	白细胞计数 (×10⁹/L)	中性粒细胞比值(%)
GNB感染组	79	33.58(22.12, 73.59)^*	8.71±4.43^*	75.98±13.02^*
对照组	81	5.00(5.00, 9.78)	6.81±3.51	69.20±14.55

组别	例数	LPS[P₅₀(P₂₅, P₇₅),pg/mL]	白细胞计数 (×10⁹/L)	中性粒细胞比值(%)
GNB感染组	79	33.58(22.12, 73.59)^*	8.71±4.43^*	75.98±13.02^*
对照组	81	5.00(5.00, 9.78)	6.81±3.51	69.20±14.55

界值(pg/mL)	敏感性	特异性	阳性预测值	阴性预测值	约登指数
10	83.54	76.54	77.65	77.65	60.08
15	83.54	85.19	84.62	84.15	68.73
20	81.01	88.89	87.67	82.76	69.90
25	69.62	91.36	88.71	75.51	60.98

界值(pg/mL)	敏感性	特异性	阳性预测值	阴性预测值	约登指数
10	83.54	76.54	77.65	77.65	60.08
15	83.54	85.19	84.62	84.15	68.73
20	81.01	88.89	87.67	82.76	69.90
25	69.62	91.36	88.71	75.51	60.98

血浆脂多糖浓度检测对器官移植患者革兰阴性细菌感染的诊断价值

The diagnosis significance of plasma lipopolysaccharide determination for Gram-negative bacterium infection in organ transplantation recipients

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