血清降钙素原水平监测对指导新生儿细菌感染抗菌疗程的意义  

Clinical significance of serum procalcitonin monitoring to guide the course of antibiotic treatment in neonatal bacterial infection

作　　者：许蔓春[1] 马恒颢[1] 任广立[1] 欧巧群[1] 李旺辉[1] 朱会英[2] 

机构地区：[1]中国人民解放军广州军区广州总医院小儿科,510010 [2]中国人民解放军广州军区广州总医院感染控制科,510010

出　　处：《国际检验医学杂志》2012年第11期1299-1300,1302,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨降钙素原(PCT)作为监测指标指导新生儿细菌感染抗菌治疗的临床意义。方法将出生3d内疑似细菌感染的130例新生儿,于抗菌药物治疗3d后检测PCT水平,根据PCT水平分为以下各组:Ⅰ组患儿PCT<0.5μg/L,排除感染,停用抗菌药物;Ⅱ组患儿PCT>0.5μg/L,提示感染。再将Ⅱ组分为:Ⅱa组,每3天检测PCT,如PCT<0.5μg/L,停用抗菌药物;Ⅱb组,应用抗菌药物至少7d,待临床症状消失且PCT<0.5μg/L后停药。分别比较各组抗菌疗程、再次感染机会和肠道菌群失调发生率。结果抗菌药物使用疗程Ⅰ组均为3d,Ⅱa组大多数患儿需6～9d,Ⅱb组患儿需10d或更长。各组停药后再次感染发生率差异无统计学意义(P>0.05)。肠道菌群失调发生率Ⅰ组与Ⅱa组比较差异无统计学意义(P>0.05)。Ⅱb组高于Ⅱa组,差异有统计学意义(P<0.05)。结论 PCT可以安全、有效地指导新生儿细菌感染治疗。Objective To explore the clinical significance of procalcitionin（PCT） concentration for the guidance of antibiotic treatment course in neonates with bacterial infection. Methods 130 neonates,less than 3 days old and with suspected bacterial infection, were enrolled and detected for PCT level 3 days after antibiotic therapy. All enrolled neonates were divided into two groups, including group I with PCT level less than 0.5 μg/L and group II with PCT level more than 0.5μg/L. Neonates in group II were further divided into two groups,including group II a, neonates in which were detected for PCT level every 3 days and antibiotics were withdrawled when PCT level was less than 0.5 μg/L,and group 11 b,neonates in which were treated by antibiotics for at least 7 days and antibiotics were withdrawled when clinical syndromes disappeared and PCT level was less than 0.5μg/L. The duration of antibiotic treatment, the risk of recurrent infection and the incidence of alteration of intestinal flora were compared between different groups. Results The duration of antibiotic therapy was 3 days in group I,almost 6--9 days in group IIa and 10 days or lon- ger in group IIb, respectively. There was no significant difference of the incidence of recurrent infection between all groups （P〉 0.05）. There was no significant difference of the incidence of alteration of intestinal flora between group I and group II a,but that in group II b was higher than in group II a（P〈0.05）. Conclusion Serum PCT concentration might be safe and effective for the guidance of antibiotic merapy in neonates with suspected bacterial infection.

关 键 词：细菌感染 降钙素原 临床方案 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]