婴儿捂热综合征血降钙素原增高的意义  

Increase of procalcitonin in infant muggy syndrome

作　　者：张新萍[1] 肖政辉[1] 

机构地区：[1]湖南省儿童医院急救中心,长沙410007

出　　处：《中国小儿急救医学》2015年第5期313-315,319,共4页Chinese Pediatric Emergency Medicine

基　　金：十二五国家科技支撑计划儿科应急救治相关技术的研究与推广应用项目（2012BA104B01）

摘　　要：目的探讨捂热综合征患儿降钙素原（procalcitonin，PCT）升高的特点和临床意义。方法收集2011年11月至2012年4月在我院PICU住院的23例捂热综合征患儿的资料，按照危重病例评分，分为高危组（5例）、中危组（12例）、低危组（6例）。按照发病前是否合并感染，分为感染组（8例）和非感染组（15例）。以门诊体检的同年龄段婴儿20例为对照组。观察PCT增高与fl^JL危重病例评分、原发感染及感染指标的关系，并进行多因素分析，探讨捂热综合征时PCT增高的可能原因。结果捂热综合征患儿PCT明显升高，高危组患儿PCT值（91．5±90．9）ng／ml；中危组患儿PCT值（81．1±74．1）ng／ml；低危组患儿PCT值（112．1±74．9）ng／ml，各组PCT值差异无统计学意义（F=0．371，P=0．732）。与对照组比较，捂热综合征患儿的白细胞计数、中性粒细胞比例、C反应蛋白值均升高，差异均有统计学意义（P均〈0．05）。感染组患儿PCT值（72．5±74．4）ng／ml，非感染组患儿PCT值（101．5±76．6）ng／ml，两组比较差异无统计学意义（t=0．873，P=0．392）。PCT升高与捂热后体温升高度数相关性较高（r=-0．362，P=0．049）。结论捂热综合征患儿的PCT增高与捂热过程有关，高热环境激发应激反应，导致PCT增高。Objective To investigate the characteristics and clinical significance of increased procal- citonin（PCT） in infant muggy syndrome（IMS）. Methods A total of 23 IMS cases admitted in PICU from Nov 2011 to Apr 2012 were enrolled. All cases were devided into three groups according to pediatric critical illness score ,high risk group（ n = 5 ）, medium risk group（ n = 12 ）, and mild risk group（ n = 6 ）. And 23 cases were also divided into infection group and no infection group according to baseline disease before onset. The relationship of PCT and pediatric critical illness score, primary infection and infection index were observed, and the possible causes of increased PCT in IMS were explored. Twenty age matched infants receiving exami- nation in clinic served as control group. Results PCT increased significantly in IMS cases. The PCT level was（91.5 ＋90.9） ng/ml in high risk group, （81.1 ~74. 1） ng/ml in medium risk group,and（ll2. 1 ~ 74. 9） ng/ml in mild risk group, there were no significant differences among three groups （ F = 0. 371, P = 0. 732）. Other infection index like leukocyte conmt, neutrophil and C reactive protein in IMS group were higher than those in the control group, and the results had significant differences （ P 〈 0.05, respectively）. The PCT level was（72. 5 ± 74.4 ） ng/ml in infection group, （ 101.5 ± 76. 6 ） ng/ml in no infection group, and there was no significant difference between two groups （ t = 0. 873, P = 0. 392）. There was no relevance be- tween increase of PCT and the incidence of infection before IMS. But PCT had higher correlation to the body tem- perature after IMS （ r = - 0. 362, P = 0. 049）. Conclusion There is correlation between the increased PCT and fever in IMS,and fever in IMS would lead to inflammation and then resulted in the increase of PCT.

关 键 词：捂热综合征 降钙素原 

分 类 号：R720.597[医药卫生—急诊医学]