•66 *安徽医药Anhui Medical and Pharmaceutical Journal 2019 Jan，23(1)代动力学的特点选择合适的给药方法，必要时不同类型抗菌药物应联合应用，并在抗菌药物的使用过程中注意于48 ~72 h评价临床疗效,及时调整抗菌药物剂量或类型[18〜。
临床医生更需注重合理应用抗生素，遵守抗生素的使用规范和原则。
参考文献[1 ]李亚平，王磊.老年患者肺部感染的药物敏感性及病原菌分布探析[J].世界最新医学信息文摘,2016,16(55) :11-12. D0I:10.3969/j. issn. 1671-3141.2016.55.007.[2] HUOI C.VANHEMS P,NIC0LLE M C,et al. Incidence of Hosp；-tal-Acquired Pneumonia, Bacteraemia and Urinary Tract InfectionsinPatients with Haematological Malignancies,2004-2010： A Surveillance-Based Study[ J ].Plos One, 2013,8(3)： e58121. DOI ：10.1371/joumal. pone. 0058121.[3]盛波，叶英，李家斌.住院病人70160例医院感染调查分析[J].安徽医药，2017,21(1):77-81.[4]陈飞飞，王煦，何海照.老年肺部感染患者的病原菌分布及药物敏感性分析[J].现代实用医学，2016,28(9) :1166-1167.[5]MTRAVTTTJ.ES M,ANZUETO A. Antibiotics for acute and chronicrespiratory infection in patients with chronic obstructive pulmonarydisease [J]. American Journal of Respiratory & Critical Care Medicine,2013 ,188(9) ：1052-1057.[6]水跃翔，周华，朱丹，等.呼吸内科下呼吸道感染病原菌分布及耐药性分析[<[].中国微生态学杂志，2014,26(8):900-902.[7]于琦，修云霞,杨翠珍.老年呼吸道感染患者病原性细菌临床检验探讨[<1].中国药物经济学，2013(4):295-296_[8]周冰，奚艳，朱益文.老年人院内肺部感染及细菌耐药性分析[J].临床合理用药杂志，2011，4(36) :185-186.[9]NOGUCHI S,YATERA K,KAWANAMI T,et al. The cHnical features of respiratory infections caused by the Streptococcus angino-sus group[J]. BMC Pulmonary Medicine,2015,15(1) ：133.[10]蒋海平.老年患者革兰阴性杆菌性肺炎的菌群分布及耐药性[J].中华医院感染学杂志，2012,22(10) :2209-2210.[11]赵霞，张国伟.老年患者下呼吸道感染病原菌检验结果分析[J].基层医学论坛，2013(13) : 1714-1715.[12]吴宗宝，李爱娟，丁式行，等.感染科呼吸内科住院患者感染病原菌分布及耐药性分析[J].浙江临床医学，2016,18 (12):2321-2321.[13] GORDON S B, BRUCE N G, GRIGG J, et al. Respiratory risksfrom household air pollution in low and middle income countries[J]. Lancet Respir M ed,2014,2(10) ：823-860.[14 ]周蓉，朱卫民.肺炎克雷伯菌分子流行病学及耐药机制研究进展[J].国外医药抗生素分册，2012,33(1):1-5.[15 ] BARTON R C, HOBSON R P, MCLOUGHUN H, et al. Assessmentof the significance of respiratory culture of Aspei^illus, in the non-neutropenic patient. A critique of published diagnostic criteria[ J].European Journal of Clinical Microbiology &Infectious Diseases,2013,32(7) ：923-928.[16] AYDEMIR 0,AYDEM IR Y,0ZD EM IR M. The role of multiplexPCR test in identification of bacterial pathogens in lower respiratorytract infections [ J ]. Pakistan Journal of Medical Sciences Online,2014,30(5) ：1011-1016.[17 ] SHINDO Y, ITO R, KOBAYASHI D, et al. Risk factors for drug-resistant pathogens in community-acquired and healthcare-associatedpneumonia. [ J ]. American Journal of Respiratory & Critical CareMedicine，2013,188(8) :985-995.[18] SURESH B K, KASTELIK J, MORJARIA J B. Role of long termantibiotics in chronic respiratory diseases. [ J ]. Respiratory Medicine,2013,107(6) ：800-815.[19]俞云松.重视细菌耐药监测提高耐药监测水平[J].中华检验医学杂志，2012,35(1):6-7.[20] WANG PH, WANG HC. Risk factors to predict drug-resistantpathogens in hemodialysis-associated pneumonia [ J ]. BMC InfectDis,2016,16(1) ：377.[21 ]黄承龙，于锋，葛卫红，等.慢性阻塞性肺疾病急性加重期的病原菌分布与抗菌药物的应用分析[J].安徽医药，2015,19(6):1199-1201.(收稿日期:2017~03-22,修回日期:2018-1(K)8)doi：10.3969/j. issn. 1009-6469.2019.01.017 ◊临床医学◊慢性肾脏病病人胃蛋白酶原i、n检测的意义周萍，焦瑞宝，章文，潘恺作者单位:铜陵市人民医院临床检验中心，安徽铜陵244009摘要：目的探讨慢性肾脏病（C K D)病人蛋白酶原I、n检测结果对肾功能减退程度评估的价值。
方法2015年10月至2016年3月铜陵市人民医院收治的117例慢性肾脏病病人，根据肾功能减退程度分四组;对照组选取84例健康者。
以酶联免 疫方法检测各组样本的胃蛋白酶原I(P G I )、胃蛋白酶原II(P G I I)水平，肌氨酸氧化酶法检测血肌酐(S C r)水平，做对比分析。
结果慢性肾脏病各组病人的 P G I 水平（p g/L)(251.62 ± 96. 36、308. 58± 101. 89、379. 54 ± 117. 09、4〇1. 59 ± 115.42)、P G I I水平（jjLg/L) (25.85 ± 16. n、25. 81± 15.79、23.52 ± 15.04、31. 31 ±21.5乃均明显高于对照组<0. 05);随着肾功能减 退程度的增加,P G I的水平逐渐増高,P G I与S&呈明显正相关性(r= 0.618 0,P <0. 05);C K D各组之间P G I I水平的差异无 统计学意义(P>〇.〇5),P G I与S&呈正相关性（「=0.2051,尸>0_05)。
结论胃功能指标P G I、P G I I 的检测结果有助于慢安徽医药Anhui Medical and Pharmaceutical Journal 2019 Jan，23(1)■67 •性肾脏病肾功能损伤程度的监测和评价,特别是在肾功能损伤的早期阶段。
关键词：肾功能不全，慢性；胃蛋白酶原类；肌酸酐；酶联免疫吸附测定Significance of pepsinogen I and II in patients with chronic kidney diseaseZHOU PingJAO Ruibao,ZHANG Wen,PAN K aiAuthor Affiliation：Department of Laboratory Medicine of Tongling Peoples Hospital,Tongling,A nhui2A A009 9ChinaA b s t r a c t：O b j e c t i v e To investigate the value of the detection results of the Pepsinogen I and I I in the evaluation of renal function in the patients with chronic kidney disease ( CKD). M e t h o d s117cases of patients with chronic kidney disease were divided into 4groups according to the degree of impairment of renal function 84healthy subjects were also selected as control group. The ELISA was applied to measure the original 1 (P G I ),pepsinogen I I(P G I I) in each sample,and the serum creatinine (S C r) level was tested by Muscle ammonia oxidase method, which were analyzed by SPSS. R e s u l t s The results of PG I levels( jxg/L) (251. 62 ±96. 36，308.58 ±101. 89,379. 54 ±117. 09,401. 59 ±115.42)and PGI I levels( p,g/L) (25.85± 16. 17,25.81± 15.79,23.52±15.04,31. 31±21. 57)in patients with chronic kidney disease groupI I were significantly higher than the control group (尸<0• 05). With the increase of the degree of renal dysfunction, PG I levels gradually increased. PG I was significantly correlated with SCr ( r = 0. 618 0, P < 0. 05) . There was no significant difference in the level of PG I I of each groups of CKD ( P > 0. 05) . PG I I is positively related to SCr (r =0. 205 1 ,P>0. 05). C o n c l u s i o n The results of PG and PG I I are helpful to the monitoring and evaluation of renal function damage in chronic kidney disease, especially in the early stage of renal injury.K e y w o r d s： Renal insufficiency, chronic ；Pepsinogens ；Creatinine ；Enzyme-linked immunosorbent assay胃蛋白酶原I(PG I )主要由胃黏膜主细胞分 泌，胃蛋白酶原n(P G n)主要由胃黏膜腺体细胞 分泌。