血清降钙素原和血浆D-二聚体水平检测在危重症患儿感染时的临床探讨  

Clinical study on the detection of serum procalcitonin and plasma D-dimer levels in critically ill children with infection

作　　者：劳庆禄[1] 李卫东[1] 

机构地区：[1]南方医科大学附属小榄人民医院儿科,广东中山528415

出　　处：《中国医师进修杂志》2013年第6期9-12,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨血清降钙素原（PCT）和血浆D-二聚体（D-D）水平检测在早期诊断小儿危重症感染中的临床价值。方法采用固相免疫色谱法和免疫比浊法检测302例危重症患儿血清PCT、血浆D-D、血浆C反应蛋白（CRP）及WBC计数。结果临床感染组（208例）患儿血清PCT阳性率和血浆D-D水平分别为96．6％（201/08）、（1．65±0．73）mg／L，均显著高于临床非感染组（94例）的10．6％（10／94）、（0．45±0．21）mg／L，差异有统计学意义（P〈0．05），而WBC计数和血浆CRP水平比较差异无统计学意义（P〉0．05）。血清PCT水平和血浆D-D水平均与患儿的病情严重程度呈正相关（P〈0．05）。结论血清PCT和血浆D-D水平检测可作为早期诊断危重症患儿感染、病情严重程度评估及疗效判断的重要敏感性指标；血浆D-D水平检测对早期判断危重症患儿感染时凝血功能异常程度与广度具有重要临床指导意义，同时为临床早期合理应用抗凝药物治疗方面提供积极有效的理论依据。Objective To investigate the clinical value of the detection of serum procalcitonin （PCT） and plasma D-dimer （D-D） levels in the early diagnosis of infection in critically ill children. Methods Solid-phase immune chromatography and immune nephelometry were used to determine the levels of serum PCT,plasma D-D,plasma C reactive protein （CRP） and WBC count in 302 critically ill children. Results The positive rate of serum PCT and the level of plasma D-D in the infected group （208 children） were significantly higher than those in the non-infected group （94 children）[ 96.6%（201/208） vs. 10.6% （10/94）, （ 1.65 ± 0.73 ） mg/L vs. （0.45 ± 0.21 ） mg/L, P 〈 0.05 ]. But there was no significant difference of plasma CRP level and WBC count between the 2 groups （P 〉 0.05）. The levels of serum PCT and plasma D-D were positively correlated to the severity of the illness （P 〈 0.05）. Conclusions The levels of serum PCT and plasma D-D are between important sensitivity markers for early diagnosis of critically ill children, illness severity assessment and therapeutic evaluation. The detection of plasma D-D plays an important role in early diagnosis of the degree and the width of coagulation disorder,and also provides the theoretic basis to use anticoagulation drugs for treating the critically ill children with infection.

关 键 词：危重病 感染 降钙素原 D-二聚体 

分 类 号：R7[医药卫生—临床医学]