目的分析连续性肾脏替代疗法治疗老年脓毒血症的疗效。方法对分析该院收治的60例老年脓毒血症患者采用连续性肾脏替代疗法治疗,分析疗效。结果死亡率16.6%;单次治疗前后患者各项指标差异有统计学意义(P0.05)。结论连续性肾脏替代疗法治疗老年脓毒血症能效果显著。

Objective To analyze the curative effect of continuous renal replacement therapy in the treatment of elderly patients with sepsis. Methods 60 cases of elderly patietns with sepsis admitted in our hosptial were given the treatment of continuous renal replacement therapy, and the curative effect was analzed. Results The mortality rate was 16.6%; the differences in indexes of the patients before and after treatment were statistically significant(P<0.05). Conclusion The effect of continuous renal replacement therapy in the treatment of elderly patietns with sepsis is significant.

目的：了解患者微创经皮肾镜取石术（mPCNL）术后发生尿源性脓毒血症的相关危险因素。方法收集某院1022例患者 mPCNL 围手术期的临床资料，对患者 mPCNL 术后发生尿源性脓毒血症的危险因素进行分析。结果1022例患者，发生尿源性脓毒血症62例，发生率为6．07％。患者经早期发现、积极治疗后均痊愈出院。logistic 逐步回归分析，结果显示，年龄（OR95％CI ：1．25～3．92）、血常规（OR95％CI ：1．25～14．00）、尿常规（OR95％CI ：2．67～10．02）及术中灌注液体量（OR95％CI ：1．37～4．18）与尿源性脓毒血症的发生密切相关。结论年龄（≥60岁）和术中灌注液体量（≥30 L）是患者 mPCNL 术后发生尿源性脓毒血症的危险因素；了解相关危险因素，有助于预防和及时治疗患者 mPCNL 术后尿源性脓毒血症。

Objective To explore the risk factors for urosepsis after minimally invasive percutaneous nephrolithot-omy(mPCNL).Methods Clinical data of 1 022 patients undergoing mPCNL were collected,risk factors for urosep-sis after mPCNL were analyzed.Results Of 1 022 patients,62 (6.07%)developed urosepsis.All patients recov-ered and discharged after early diagnosis and active treatment.Logistic regression analysis showed that age(OR95%CI :1 .25-3.92),blood routine examination (OR95%CI :1 .25-14.00),urine routine examination(OR95%CI :2.67-10.02)and volume of intraoperative fluid perfusion(OR95%CI :1 .37-4.18)were closely related to urosepsis fol-lowing mPCNL.Conclusion Age(≥60 years)and intraoperative perfusion fluid volume (≥30L)during operation are the risk factors for urosepsis following mPCNL,The recognition of the related risk factors is helpful for the pre-vention and timely treatment of urosepsis following mPCNL.

目的探讨多重聚合酶链式反应(PCR)在脓毒血症病原体检测中的灵敏度、特异性及检测时间,为多重PCR在脓毒血症病原体检测中的应用提供理论依据。方法采用多重PCR和血培养检测医院40例脓毒血症患者血液中的病原体,并比较两种检测方法的灵敏度、特异性、检测速度、检测菌种的差异,并以同期40名健康体检者血标本作为对照;采用SPSS 15.0软件进行数据处理,检测阳性结果以率的形式表示,并进行χ2检验。结果对照组中两种方法的阳性率差异无统计学意义,脓毒血症组多重PCR检测的阳性率为55.0%,血培养为82.5%,两者比较差异有统计学意义(P0.05),且血培养检测出18例脓血症患者中共有11例PCR检测为阳性,占61.1%;多重PCR特异性为80.7%,灵敏度为95.7%;脓毒血症组多重PCR的平均检测时间为(6±0.56)h,血培养法为(30.78±1.45)h,差异有统计学意义(P0.05);从22份阳性血培养中共分离出4种病原菌,分别为金黄色葡萄球菌10株、铜绿假单胞菌7株、鲍氏不动杆菌3株、表皮葡萄球菌2株,多重PCR均能检测上述病原菌的DNA。结论在脓毒血症病原学的检测中,多重PCR较血培养具有更高的敏感性和特异性,检测时间也较血培养明显缩短,有利于脓毒血症病原体的快速检测,指导临床用药。

OBJECTIVE To investigate the sensitivity ,specificity ,and detection time of multiplex polymerase-chain-reaction (PCR) in the detection of pathogens causing sepsis so as to provide theoretical basis for application of multiples PCR in detection of the pathogens .METHODS By means of the multiplex PCR and blood culture ,the pathogens isolated from the blood of 40 sepsis patients were detected ,then the sensitivity ,specificity ,detection time ,and species of detected pathogens were observed and compared between the two detection methods ;mean-while ,40 healthy people who underwent the physical examination were assigned as the control group ,the data were analyzed with the use of SPSS 15 .0 software ,the positive results were defined as rate ,and the chi-square test was carried out .RESULTS In the control group ,there was no significant difference in the positive rate between the two methods ;in the sepsis group ,the positive rate of the multiples PCR was 55 .0% ,the blood culture 82 .5%

目的：探讨血清降钙素原（ PCT）水平检测在脓毒血症预后判断中的临床价值。方法选取113例感染患者为研究对象，根据是否伴有脓毒血症分为观察组（脓毒血症）和对照组（非脓毒血症）。于患者入院时抗生素治疗前抽取患者静脉血2 mL应用免疫发光法检测PCT水平。比较两组入院时及入院后PCT水平，分析其与患者病情变化及预后的关系。结果观察组PCT（11．03±6．21）ng／mL，显著高于对照组的[（0．81±1．61）ng／mL]（t＝8．507，P＜0．01）；脓毒血症死亡患者血清PCT水平随着时间推移明显上升（F＝5．061，P＜0．05）；无效患者血清PCT水平随病情加重而显著升高（F＝4．793，P＜0．05）；好转患者血清PCT水平随病情好转而降低（F＝6．009，P＜0．05）。且PCT＜10 ng／mL者病死率（14．89％）明显低于PCT≥10 ng／mL患者（72．22％）。结论 PCT对预测脓毒血症的预后具有重要的临床价值，值得临床推广和应用。

Objective To explore the correlation of serum procalcitonin and prognosis of neonatal sepsis. Methods 113 cases of infection were selected as the objects of study,which were divided into the observation group ( sepsis) and control group ( non sepsis) according to the presence of sepsis.2mL venous blood was selected when patients were admitted to hospital before antibiotic treatment.The level of PCT was detected by immunoluminometric assay.PCT level at admission and after treatment were used to analyze the relationship between changes and the severity and prognosis of patients.Results PCT level of the observation group [(11.03 ±6.21)ng/mL] were higher than that of the control group [(0.81 ±1.61)ng/mL] (t=8.507,P<0.01),Sepsis and death in patients with serum PCT values increased significantly over time (F=5.061,P<0.05);invalid value of serum PCT in patients with disease exacerbation was significantly higher(F=4.793,P<0.05);improved serum PCT values in patients with the diseas

内皮细胞在凋亡或激活条件下可以释放一种直径为0.05~1的囊泡状物质,我们称其为内皮细胞微粒。在脓毒血症中我们发内皮细胞微粒水平明显升高,这说明内皮细胞微粒与脓毒血症之间存在着一定关系。内皮细胞微粒通过自身表达的物质及刺激其他细胞表达的物质而在炎症、凝血、血管功能改变中产生重要作用。该研究就内皮细胞微粒的形成及与脓毒血症的关系做一概述。

Under apoptosis or activated conditions, the endothelial cells can shed a diameter of 0.05-1vesicle-like substances, named endothelial microparticles (EMPs). It has been documented that the level of EMPs significantly increased in sepsis, which indicated that there is a certain relationship between the EMPs and sepsis. The substances expressed by EMPs and other cells stimulated by EMPs play an important role in inflammation, coagulation, vascular functional changes. This review was written to give an outline about the formation of EMPs and the relationship between EMPs and sepsis.