血流感染病原菌与淋巴细胞降低的影响因素分析

Analysis of influencing factors of pathogenic bacteria and lymphocyte reduction in patients with bloodstream infection

    摘要
  • 摘要: 目的 分析血流感染病原菌与淋巴细胞降低的影响因素分析。方法 回顾性分析2016年1月-2019年1月西宁市第一人民医院收治的121例血流感染患者的临床资料,依据患者血培养当日外周血淋巴计数将其分为淋巴细胞降低组（淋巴细胞<1.0×109）85例和对照组（淋巴细胞≥1.0×109）36例。比较淋巴细胞降低与血流感染患者的细菌种类和基础疾病等情况,归纳血流感染患者淋巴细胞降低的影响因素。结果 淋巴细胞降低组患者检出屎肠球菌占7.06%（6/85）和粪肠球菌占5.88%（5/85）感染比例高于对照组（P=0.038,0.019）。淋巴细胞降低组患者基础疾病为肿瘤的比例高于对照组（P<0.05）。两组患者的其他基础疾病比例比较差异无统计学意义。单因素分析结果显示,淋巴细胞降低组与对照组患者的年龄、C-反应蛋白、降钙素原（PCT）、CD3+T、CD4+T、CD8+T、CD4+/CD8+T、功能不全器官数量和肿瘤有一定差异（P<0.05）。多因素分析结果显示,低龄、合并肿瘤是血流感染患者淋巴细胞降低的影响因素（P<0.05）。结论 血流感染患者多合并淋巴细胞降低,淋巴细胞降低患者的屎肠球菌和粪肠球菌感染比例较高,基础疾病多为肿瘤,低龄、合并肿瘤为血流感染患者淋巴细胞降低的影响因素,临床中应对此类患者加强监测。

     

    Abstract: OBJECTIVE To analyze the influencing factors of pathogenic bacteria and lymphocyte reduction in patients with bloodstream infection. METHODS The clinical data of 121 patients with bloodstream infection admitted to the first people’s hospital of Xining from Jan. 2016 to Jan. 2019 were retrospectively analyzed. According to the peripheral blood lymphocyte count on the day of blood culture, the patients were divided into 85 cases of lymphopenia group（lymphocyte ＜1.0×109 ） and 36 cases of control group（lymphocyte ≥1.0×109 ）. The bacteria types and basic diseases of patients with bloodstream infection and lymphocyte reduction were compared to summarize the influencing factors of lymphocyte reduction in patients with bloodstream infection. RESULTS The infection rate of Enterococcus faecium 57.06%（6/85） and Enterococcus faecalis 55.88%（5/85） in the lymphocytopenia group was significantly higher than that in the control group（P=0.038 and P=0.019, respectively）. The proportion of patients with lymphocytopenia in which the underlying disease was tumor was significantly higher than that in the control group（P＜0.05）. There was no significant difference in the proportion of other basic diseases between the two groups. Univariate analysis showed that age, C-reactive protein, procalcitonin（PCT）, CD3+T, CD4+T, CD8+ T, CD4+/CD8+T, the number of organs with incomplete function and tumor had certain influence of patients in the lymphocytopenia group and the control group（P＜0.05）. The multivariate analysis results showed that young age and combined tumors were the influencing factors of lymphocyte reduction in patients with bloodstream infection. CONCLUSION Patients with bloodstream infection were more likely to have decreased lymphocytes. The proportion of E. faecalis and E. faecalis infection in patients with decreased lymphocytes was higher. The basic diseases were mostly tumors, and young age and combined tumors were the influencing factors of lymphopenia in patients with bloodstream infection. Such patients should be closely monitored in clinical practice.

     

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