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

摘要

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.%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。