降钙素原和C反应蛋白在小儿脓毒症早期诊断及判断病情严重程度中的价值  

Value of PCT and CRP in early diagnosis and severity of the judgment in children with sepsis

作　　者：黄晓雯[1] 马力忠[1] 莫庆仪[1] 梁桂明[1] 刘占国 

机构地区：[1]南方医科大学附属中山博爱医院儿童重症监护室,广东中山528400 [2]南方医科大学珠江医院重症医学科,广东广州510282

出　　处：《西部医学》2017年第5期627-631,共5页Medical Journal of West China

基　　金：国家自然科学基金(81101451)

摘　　要：目的探讨降钙素原(PCT)、C反应蛋白(CRP)在小儿脓毒症早期诊断及判断病情严重程度中的价值。方法选取2013年1月至2015年6月间来院就诊并接受治疗的104例感染性疾病患儿,根据病情分为脓毒症组63例和非脓毒症组41例,对两组患儿血清中的PCT和CRP进行测定并进行分析对比。结果脓毒症组患儿的PCT和CRP水平均显著性高于非脓毒症组(P<0.05);脓毒症组患儿中严重脓毒症组患儿的PCT和CRP水平均显著性高于非严重组(P<0.05);非严重组患儿的PCT和CRP水平均显著性高于非脓毒症组(P<0.05);PCT诊断脓毒症的曲线下面积为(0.9±0.1),敏感度为90.1%,特异度为85.6%,诊断准确率为83.9%。CRP诊断脓毒症的曲线下面积为(0.7±0.1),此时敏感度为79.8%,特异度为69.9%,诊断准确率为70.5%。PCT与CRP曲线下面积、敏感度以及诊断准确率比较均差异有统计学意义(均P<0.05)。结论在小儿脓毒症的早期诊断中,血清降钙素原检测较血清C反应蛋白检测相比有较高的敏感性和特异性,在判断脓毒症病情严重程度方面,PCT检测和CRP检测相比两者临床价值相当。Objective To investigate the value of Procalcitonin （PCT） and C-reactive protein （CRP） in early diagnosis and severity of the judgment in children with sepsis. Methods 104 children with infection were treated in our hospital from January 2013 to June 2015. The children with sepsis were divided into sepsis group （63 cases） and non-sepsis group （41 cases）, according to the disease. The PCT and CRP were compared in each groups. Results The PCT and CRP in sepsis group were all significantly higher than that in non-sepsis group （P〈0.05）. The PCT and CRP in severe sepsis group were all significantly higher than that in non-severe sepsis group （P〈0. 05）. The PCT and CRP in non-severe sepsis group were all significantly higher than that in non-sepsis group （P〈0.05）. The area under the curve in PCT was （0.9 ± 0. 1）. The sensitivity was 90. 1%. The specificity was 85.6%. The diagnostic accuracy was 83.9%. The area under the curve in CRP was （0. 7± 0. 1）, the sensitivity was 79.8 %, the specificity was 69.9 % and the diagnostic accuracy was 70.5 %, the differences of area under the curve, sensitivity and diagnostic accuracy between PCT and CRP were statistically significant（ all P〈0.05） Conclusion In the early diagnosis of children sepsis, compared with CRP, PCT has higher sensitivity and specificity. In terms of judging the severity of sepsis, PCT and CRP has the equal clinical value.

关 键 词：降钙素原(PCT) C反应蛋白(CRP) 小儿脓毒症 早期诊断 病情严重程度 

分 类 号：R725.9[医药卫生—儿科]