CAJ | 학술논문

目的了解细菌、病毒及支原体感染引起脓毒症血清降钙素原(procalcitonin,PCT)的水平,明确血清PCT判断引起儿童脓毒症常见病原的作用.方法回顾性分析2011年2月1日至2012年9月1日入住湖南省儿童医院PICU确诊细菌、病毒、支原体感染引起脓毒症患儿330例,检测其入院时及治疗3d后的PCT水平,分析不同血清PCT水平下细菌、病毒及支原体感染引起的脓毒症的分布差异.分析细菌、病毒及支原体感染引起脓毒症的血清PCT水平在入院时与治疗3d时的差异.结果细菌感染引起的脓毒症血清PCT水平明显升高,病毒及支原体感染引起的血清PCT水平升高不明显,分别为0.71 (8.14) ng/ml、0.15 (1.68) ng/ml、0.28 (1.89) ng/ml.按PCT水平分为0.05～ ng/ml、0.5～ ng/ml、2～ng/ml、10 ～ 300 ng/ml组,四组中细菌、病毒及支原体感染引起的脓毒症的分布不同,差异有统计学意义(x2=84.50,P＜0.01).细菌感染引起的脓毒症抗炎治疗3d后,PCT水平较入院时明显下降[0.32(5.68) ng/ml vs 0.71 (8.14) ng/ml],差异有统计学意义(U=19.34,P＜0.05).结论 PCT判断儿童脓毒症病原学有一定作用.PCT明显升高及抗炎治疗后PCT明显降低提示细菌感染可能性大,PCT升高不明显以病毒及支原体感染为主,不能完全排除细菌感染.
목적 료해세균、병독급지원체감염인기농독증혈청강개소원(procalcitonin,PCT)적수평,명학혈청PCT판단인기인동농독증상견병원적작용.방법 회고성분석2011년2월1일지2012년9월1일입주호남성인동의원PICU학진세균、병독、지원체감염인기농독증환인330례,검측기입원시급치료3d후적PCT수평,분석불동혈청PCT수평하세균、병독급지원체감염인기적농독증적분포차이.분석세균、병독급지원체감염인기농독증적혈청PCT수평재입원시여치료3d시적차이.결과 세균감염인기적농독증혈청PCT수평명현승고,병독급지원체감염인기적혈청PCT수평승고불명현,분별위0.71 (8.14) ng/ml、0.15 (1.68) ng/ml、0.28 (1.89) ng/ml.안PCT수평분위0.05～ ng/ml、0.5～ ng/ml、2～ng/ml、10 ～ 300 ng/ml조,사조중세균、병독급지원체감염인기적농독증적분포불동,차이유통계학의의(x2=84.50,P＜0.01).세균감염인기적농독증항염치료3d후,PCT수평교입원시명현하강[0.32(5.68) ng/ml vs 0.71 (8.14) ng/ml],차이유통계학의의(U=19.34,P＜0.05).결론 PCT판단인동농독증병원학유일정작용.PCT명현승고급항염치료후PCT명현강저제시세균감염가능성대,PCT승고불명현이병독급지원체감염위주,불능완전배제세균감염.
Objective To investigate the serum procalcitonin (PCT) levels in sepsis caused by the bacteria,virus and mycoplasma and explore the role of PCT in etiology diagnosis of sepsis in children.Methods Three hundreds and thirty critically ill children with sepsis caused by bacteria,virus and mycoplasma admitted in PICU of Hunan Children' s Hospital from Feb 1,2011 to Sep 1,2012 were reviewed and analyzed.The PCT levels were measured at admission and day 3.The differences in accidence of sepsis caused by bacteria,viruses and mycoplasma according to different serum PCT levels were analyzed.The differences of PCT levels at admission and day 3 in sepsic children caused by bacteria,viruses and mycoplasma were analyzed.Results The level of serum PCT in sepsis caused by bacterial infection were distinctly increased,caused by virus and mycoplasma infections was not obvious but the increases of serum PCT [0.71 (8.14)ng/ml,0.15 (1.68) ng/ml,0.28 (1.89) ng/ml].According to various PCT levels(0.05 ～ ng/ml,0.5 ～ng/ml,2 ～ ng/ml,10 ～ 300 ng/ml),the differences of accidence of sepsis caused by bacteria,virus and mycoplasma were also statistically significant(x2 =84.50,P ＜ 0.01).The PCT level of septic children caused by bacterial infection in day 3 was significantly decreased compared with that at admission [0.32 (5.68) ng/ml vs 0.71 (8.14) ng/ml] (U =19.34,P ＜0.05).Conclusion PCT plays a certain role in etiology diagnosis of sepsis in children.The increased PCT levels which can be reduced by anti-inflammatory treatment indicate the likelihood of bacterial infection and sepsis.The increase of PCT induced by viral and mycoplasma infections is not obvious,but bacterial infection can not be completely ruled out.