中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2012年
7期
423-426
,共4页
王小红%董晨明%杨朝晖%张红松%牟成华%张虹
王小紅%董晨明%楊朝暉%張紅鬆%牟成華%張虹
왕소홍%동신명%양조휘%장홍송%모성화%장홍
多重聚合酶链反应%呼吸机相关性气管-支气管炎%呼吸机相关性肺炎%致病菌
多重聚閤酶鏈反應%呼吸機相關性氣管-支氣管炎%呼吸機相關性肺炎%緻病菌
다중취합매련반응%호흡궤상관성기관-지기관염%호흡궤상관성폐염%치병균
Multiplex polymerase chain reaction%Ventilator-associated trachea-bronchitis%Ventilator-associated pneumonia%Pathogen
目的 探讨多重聚合酶链反应(PCR)技术在快速检测呼吸机相关性气管-支气管炎(VAT)和呼吸机相关性肺炎(VAP)常见致病菌中的临床作用和价值.方法 留取75例外科重症监护病房(ICU)机械通气并发VAT或VAP患者的痰标本,进行细菌培养、普通PCR、多重PCR检测,比较3种方法对致病菌检出率的差异.结果 细菌培养法对金黄色葡萄球菌、鲍曼不动杆菌、大肠埃希杆菌、铜绿假单胞菌和肺炎克雷伯杆菌分离阳性检出率分别为50.7％、45.3％、30.7％、41.3％和58.7％,普通PCR阳性检出率分别为88.0％、89.3％、78.7％、85.3％和93.3％,多重PCR阳性检出率分别为92.1％、90.7％、82.7％、89.3％和96.0％.普通PCR和多重PCR对5种致病菌的阳性检出率均高于细菌培养(均P＜0.05);且多重PCR较普通PCR具有快速检测的优点.结论 与细菌培养比较,普通PCR和多重PCR对VAT和VAP5种常见致病菌的阳性检出率高,且多重PCR可有效节省人力、财力.
目的 探討多重聚閤酶鏈反應(PCR)技術在快速檢測呼吸機相關性氣管-支氣管炎(VAT)和呼吸機相關性肺炎(VAP)常見緻病菌中的臨床作用和價值.方法 留取75例外科重癥鑑護病房(ICU)機械通氣併髮VAT或VAP患者的痰標本,進行細菌培養、普通PCR、多重PCR檢測,比較3種方法對緻病菌檢齣率的差異.結果 細菌培養法對金黃色葡萄毬菌、鮑曼不動桿菌、大腸埃希桿菌、銅綠假單胞菌和肺炎剋雷伯桿菌分離暘性檢齣率分彆為50.7％、45.3％、30.7％、41.3％和58.7％,普通PCR暘性檢齣率分彆為88.0％、89.3％、78.7％、85.3％和93.3％,多重PCR暘性檢齣率分彆為92.1％、90.7％、82.7％、89.3％和96.0％.普通PCR和多重PCR對5種緻病菌的暘性檢齣率均高于細菌培養(均P＜0.05);且多重PCR較普通PCR具有快速檢測的優點.結論 與細菌培養比較,普通PCR和多重PCR對VAT和VAP5種常見緻病菌的暘性檢齣率高,且多重PCR可有效節省人力、財力.
목적 탐토다중취합매련반응(PCR)기술재쾌속검측호흡궤상관성기관-지기관염(VAT)화호흡궤상관성폐염(VAP)상견치병균중적림상작용화개치.방법 류취75예외과중증감호병방(ICU)궤계통기병발VAT혹VAP환자적담표본,진행세균배양、보통PCR、다중PCR검측,비교3충방법대치병균검출솔적차이.결과 세균배양법대금황색포도구균、포만불동간균、대장애희간균、동록가단포균화폐염극뢰백간균분리양성검출솔분별위50.7％、45.3％、30.7％、41.3％화58.7％,보통PCR양성검출솔분별위88.0％、89.3％、78.7％、85.3％화93.3％,다중PCR양성검출솔분별위92.1％、90.7％、82.7％、89.3％화96.0％.보통PCR화다중PCR대5충치병균적양성검출솔균고우세균배양(균P＜0.05);차다중PCR교보통PCR구유쾌속검측적우점.결론 여세균배양비교,보통PCR화다중PCR대VAT화VAP5충상견치병균적양성검출솔고,차다중PCR가유효절성인력、재력.
Objective To explore the clinical utility of multiple polymerase chain reaction (M-PCR) in the rapid detection of the common pathogens in ventilator-associated trachea - bronchitis ( VAT ) and ventilator-associated pneumonia (VAP).Methods Sputum samples of 75 patients complicated VAT or VAP in surgical intensive care unit (SICU),were examinated by bacterial culture,ordinary PCR,the M-PCR detection.The pathogen detection rates among three methods were compared.Results The Staphylococcus aureus,Acinetobacter baumannü,Escherichia coli,Pseudomonas aeruginosa and Klebsiella pneumoniae of the positive detection rates were 50.7％,45.3％,30.7％,41.3％ and 58.7％ by bacterial culture.By ordinary PCR,the positive detection rates were respectively 88.0％,89.3％,78.7％,85.3％ and 93.3％,and by M-PCR,the positive detection rates were respectively 92.1％,90.7％,82.7％,89.3％ and 96.0％.The positive rates of five common pathogens of ordinary PCR and M-PCR were higher than those of bacterial culture (all P＜0.05).The M-PCR had merit for rapid detection compared with ordinary PCR.Conclusion Compared with bacterial culture,ordinary PCR and M-PCR yield higher positive rates in identifyying five common pathogens of VAT and VAP,meanwhile,it also demonstrated the tendency that M-PCR may save cost and labor power.
