降钙素原测定在儿科感染性疾病中的应用

    The clinical application of procalcitonin determination in pediatric infectious disease

    • 摘要: 目的:探讨细菌感染性疾病、非细菌感染性疾病患儿血清降钙素原(procalcitonin,PCT)的水平与临床病情严重程度的相关性。方法:将179例住院患儿分为细菌感染组97例、病毒感染组59例和非感染组23例,比较3组患儿血清PCT水平变化。将细菌感染组中符合全身炎症反应综合征诊断标准者52例进行危重病例评分(PCIS),观察患儿PCT水平与临床感染严重程度之间的相关性。结果:细菌感染组PCT水平均高于病毒感染组和非感染组(P0.01);以0.5ng/ml为临界值,PCT对于诊断细菌感染的灵敏度为80.41%,特异度为82.93%;以2.0ng/ml为临界值,PCT对于诊断细菌感染的灵敏度为30.93%,特异度为98.78%。PCIS评分与PCT水平呈负相关关系,与临床病情严重程度呈正相关关系(P0.01)。结论:PCT可以早期鉴别细菌与非细菌感染,指导抗生素合理使用,同时可以预警全身严重感染,指导临床治疗,判断疾病预后。

       

      Abstract: Objective:To investigate the correlation between serum procalcitonin(PCT)level in children with or without bacterial infection and clinical severity of disease.Methods:One hundred and seventy-nine children were divided into bacterial infection group(97 cases),virus infection group(59 cases)and uninfection group(23 cases).The levels of PCT in three groups were compared.Fifty-two cases in bacterial infection group who accorded wih the diagnostic criteria of systemic inflammatory response syndrome were assessed with pediatric critical illness score(PCIS).The correlation between PCT level and severity of clinical infection was observed.Results:The level of PCT in bacterial infection group was significantly higher than those in virus infection and uninfection group(P0.01).As the critical value for 0.5 ng/ml,the sensitivity and specificity of PCT in the diagnosis of bacterial infection were 80.41% and 82.93%,respectively.As the critical value for 2.0 ng/ml,the sensitivity and specificity of PCT in the diagnosis of bacterial infection were 30.93% and 98.78%,respectively.PCT level increased with PCIS scores decreasing.PCIS score was negatively correlated with PCT level,and positively correlated with the clinical severity of the disease(P0.01).Conclusions:PCT can be used to diagnose the early bacterial and non-bacterial infection,guide the rational use of antibiotics,warn whole body serious infection,guide clinical treatment and determine the prognosis of the disease.

       

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