动态监测血降钙素原对小儿肺炎临床诊断价值的分析  

Analysis of the value of dynamic monitoring of serum procalcitonin in clinical diagnosis of pneumonia in children

作　　者：李静[1] 董艳[1] 刘文考 盛梦娟 Li Jing;Dong Yan;Liu Wenkao;Sheng Mengjuan(Hospital of Traditional Chinese and Western Medicine of Changping District,Beijing City,Beijing 102208)

机构地区：[1]北京市昌平区中西医结合医院,北京102208

出　　处：《中国社区医师》2021年第5期105-107,共3页Chinese Community Doctors

摘　　要：目的:探讨动态监测血清降钙素原(PCT)对小儿肺炎的临床诊断价值。方法:2019年7-12月收治肺炎患儿100例,按病原体感染情况分为细菌性肺炎53例、支原体肺炎37例、病毒性肺炎10例;选取健康体检儿童30例,作为健康组。53例细菌性肺炎患儿治疗后好转38例(好转组),未好转15例(未好转组)。比较各组患儿PCT水平,并比较细菌性肺炎好转组与未好转组各项临床指标水平,分析细菌性肺炎患儿血清PCT水平和预后评分的相关性。结果:入院第1天,细菌感染组血清PCT水平明显高于病毒感染组、支原体感染组及健康组,差异有统计学意义(P<0.01)。细菌性肺炎好转组治疗第4天PCT水平较第1天有明显下降,且明显低于未好转组,差异均有统计学意义(P<0.01);好转组治疗第7天PCT水平低于第4天,差异有统计学意义(P<0.01)。细菌性肺炎好转组退热时间、咳嗽停止时间、肺部啰音消失时间、肺部炎症消失时间、住院时间、抗生素使用时间、预后评分及住院费用均低于未好转组,差异有统计学意义(P<0.05)。细菌性肺炎患儿血清PCT水平与预后评分呈正相关(r=0.879,P=0.001)。结论:血清PCT水平可用于小儿肺炎临床病原学诊断和鉴别诊断,并评价临床疗效。Objective:To explore the clinical value of dynamic monitoring of serum procalcitonin(PCT)in clinical diagnosis of pneumonia in children.Methods:From July to December 2019,100 cases of children with pneumonia were enrolled,according to pathogen infection,there were 53 cases of bacterial pneumonia,37 cases of mycoplasma pneumonia and 10 cases of viral pneumonia.30 healthy children were selected as health group.After treatment,among 53 children with bacterial pneumonia,38 cases improved(improvement group),15 cases did not improve(non-improvement group).The PCT level of children in each group was compared,the clinical indexes of improvement group and non-improvement group were compared,the correlation between serum PCT level and prognosis score in children with bacterial pneumonia were also compared.Results:On the first day of admission,the level of serum PCT in bacterial infection group was significantly higher than that in viral infection group,mycoplasma infection group and healthy group,the difference was statistically significant(P<0.01).The improvement group on the 4th day of treatment,PCT level was significantly lower than the 1st day and significantly lower than the non-improvement group,the difference was statistically significant(P<0.01).The PCT level in the improvement group was lower on the 7th day of treatment than on the 4th day,the difference was statistically significant(P<0.01).The fever clearance time,cough stopping time,lung rales disappear time,lung inflammation disappear time,length of hospital stays,antibiotic use time,prognosis score and hospital expenses in the improvement group were lower than those in the non-improvement group,the differences were statistically significant(P<0.05).Serum PCT levels were positively correlated with prognostic scores in children with bacterial pneumonia(r=0.879,P=0.001).Conclusion:Serum PCT level can be used in clinical etiological diagnosis and differential diagnosis of pneumonia in children and it can evaluate clinical efficacy.

关 键 词：肺炎 抗生素 PCT 诊断价值 

分 类 号：R725.6[医药卫生—儿科]