感染性疾病患儿血清降钙素原的单中心前瞻性研究  

Single-center prospective study of serum procalcitonin concentrations in children with infectious diseases

作　　者：林业鑫[1] 程超[2] 李玖军[1] 

机构地区：[1]中国医科大学附属盛京医院PICU,沈阳110004 [2]中国医科大学,沈阳110001

出　　处：《国际儿科学杂志》2015年第2期218-221,共4页International Journal of Pediatrics

摘　　要：目的 了解降钙素原（procalcitonin,PCT）与儿童感染性疾病致病原及与病情危重程度的关系.方法 该研究为感染性疾病患儿血清降钙素原的单中心前瞻性研究.选择2011年4月至2013年4月盛京医院PICU感染性疾病患儿95例,并根据病原体分为3组（肺炎支原体感染组30例,病毒感染组30例,细菌感染组35例）;不同病原组依据简化小儿危重症评分分为3组（非危重组、危重组、极危重组）;将细菌感染组患儿分为革兰阳性菌组（20例）、革兰阴性菌组（15例）;选择同期非感染性疾病儿童20例作为对照组.血清PCT在盛京医院检验科统一检测,应用VIDAS BRAHMS PCT法检测.结果 对照组、细菌感染组、病毒感染组、支原体感染组的血清PCT浓度分别为（0.41±n 34） μg/L、（2.56±0.38） μg/L、（0.52±0.44） μg/L、（0.21 ±0.10） μg/L.PCT≥0.5 μg/L作为阳性界值.细菌感染组PCT阳性率与对照组比较差异有显著性（x2=28.05,P＜0.05）.细菌感染组患儿血清PCT浓度高于肺炎支原体感染组、病毒感染组及对照组（P＜0.05）;细菌感染组中,革兰阴性菌组血清PCT浓度明显高于革兰阳性菌组（P＜0.05）.肺炎支原体感染组、病毒感染组血清PCT浓度与对照组比较差异无统计学意义（P＞0.05）.患儿血清PCT浓度与简化小儿危重症评分呈显著负相关（r=-0.579～-0.793,P＜0.05）.PCT浓度越高的患儿病情越重,相关并发症越多,住院时间越长.结论 PCT可作为鉴别细菌感染与肺炎支原体感染、病毒感染的敏感指标.在感染的早期诊断中,PCT可反映病情的严重程度.Objective To explore the change of serum procalcitonin （PCT）in infectious diseases and the relationship between PCT and the severity of illness in children.Methods This was a single-center prospective study of serum procalcitonin concentration in children with infectious diseases.Ninty-five children with infectious diseases （mycoplasma infection 30 cases,viral infection 30 cases,bacterial infection 35 cases）,hospitalized in PICU of Shengjing Hospital from April 2011 to April 2013,were divided into three groups：non-serious group（64 cases）,serious group（20 cases）and very serious group（11 cases）according to pediatric critical illness score（PCIS）.Bacterial infectious patients were divided into two groups：gram positive bacterial group（20cases）,gram negative bacterial group（15 cases）.Twenty children of non-infectious diseases during the same period were selected as the control group.Serum PCT levels were detected by using VIDAS BRAHMS PCT detection system（rapid semi-quantitative PCT test）.Laboratory detection was conducted in Department of Laboratory Medicine,Shengjing Hospital of China Medical University.Results The serum PCT levels of the control,the bacterial infection,virus infection,and mycoplasma infection group were （0.41 ± 0.34） μg/L,（2.56 ± 0.38）μg/L,（0.52 ±0.44） μg/L and（0.21 ±0.10） μg/L.The serun PCT levels higher than or equal to 0.5 μg/L were defirned as positive.There was significant difference in PCT positive rate between bacterial infection group and the control grouP（x2 =28.05,P 〈0.05）.The serum PCT levels of children with infectious diseases were higher than those of non-infection group,mycoplasma infection group and virus infection group（P 〈 0.05）.Besides,the PCT value of gram negative bacillus infection group was also obvious higher than gram positive infection group.There was no significant difference among the non-infection group,mycoplasma infection group and virus infection group（P 〉 0.05）.There was significant ne

关 键 词：感染 降钙素原 小儿危重症评分 细菌耐药 

分 类 号：R725.1[医药卫生—儿科]