中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2013年
7期
755-759
,共5页
贺彬%祝益民%卢秀兰%黄娇甜
賀彬%祝益民%盧秀蘭%黃嬌甜
하빈%축익민%로수란%황교첨
降钙素原%重症儿童%痰培养%器官功能障碍%预后
降鈣素原%重癥兒童%痰培養%器官功能障礙%預後
강개소원%중증인동%담배양%기관공능장애%예후
Procalcitonin%Critically ill children%Sputum culture%Organ dysfunction%Prognosis
目的 分析血清降钙素原(procalcitonin,PCT)升高危重儿童的临床资料,探讨降钙素原对重症儿童病情的预测价值.方法 回顾性收集201 1年8月至2012年3月湖南省儿童医院重症监护室收治的入院时PCT升高(PCT ＞0.5 ng/ml)的危重患儿392例,对其临床、病情演变、痰培养、器官功能及预后进行总结和分析.连续变量比较使用t检验、F检验,分类变量应用X2检验,相关性采用Pearson相关分析.结果 血清PCT水平与其他炎症标志物C-反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞比率(NEUT％)差异具有统计学意义(P＜0.01).痰细菌培养阳性时PCT水平明显升高(P＜0.05),而CRP、WBC、NEUT％变化不明显(P＞0.05).脏器功能损伤时PCT水平明显升高(P＜0.01),PCT测定值越高,发生多个器官功能衰竭的可能性越大.63例死亡患儿入院时PCT水平达到(62.43±70.19) ng/ml,明显高于存活患者(P＜0.01).结论 监测PCT水平不但能快速判定危重患儿是否合并细菌感染,而且能反映患儿是否出现器官功能障碍,还能客观判断病情严重程度及评估患儿预后,对提高重症患儿生存率及改善重症患儿生活质量起到积极作用.
目的 分析血清降鈣素原(procalcitonin,PCT)升高危重兒童的臨床資料,探討降鈣素原對重癥兒童病情的預測價值.方法 迴顧性收集201 1年8月至2012年3月湖南省兒童醫院重癥鑑護室收治的入院時PCT升高(PCT ＞0.5 ng/ml)的危重患兒392例,對其臨床、病情縯變、痰培養、器官功能及預後進行總結和分析.連續變量比較使用t檢驗、F檢驗,分類變量應用X2檢驗,相關性採用Pearson相關分析.結果 血清PCT水平與其他炎癥標誌物C-反應蛋白(CRP)、白細胞計數(WBC)、中性粒細胞比率(NEUT％)差異具有統計學意義(P＜0.01).痰細菌培養暘性時PCT水平明顯升高(P＜0.05),而CRP、WBC、NEUT％變化不明顯(P＞0.05).髒器功能損傷時PCT水平明顯升高(P＜0.01),PCT測定值越高,髮生多箇器官功能衰竭的可能性越大.63例死亡患兒入院時PCT水平達到(62.43±70.19) ng/ml,明顯高于存活患者(P＜0.01).結論 鑑測PCT水平不但能快速判定危重患兒是否閤併細菌感染,而且能反映患兒是否齣現器官功能障礙,還能客觀判斷病情嚴重程度及評估患兒預後,對提高重癥患兒生存率及改善重癥患兒生活質量起到積極作用.
목적 분석혈청강개소원(procalcitonin,PCT)승고위중인동적림상자료,탐토강개소원대중증인동병정적예측개치.방법 회고성수집201 1년8월지2012년3월호남성인동의원중증감호실수치적입원시PCT승고(PCT ＞0.5 ng/ml)적위중환인392례,대기림상、병정연변、담배양、기관공능급예후진행총결화분석.련속변량비교사용t검험、F검험,분류변량응용X2검험,상관성채용Pearson상관분석.결과 혈청PCT수평여기타염증표지물C-반응단백(CRP)、백세포계수(WBC)、중성립세포비솔(NEUT％)차이구유통계학의의(P＜0.01).담세균배양양성시PCT수평명현승고(P＜0.05),이CRP、WBC、NEUT％변화불명현(P＞0.05).장기공능손상시PCT수평명현승고(P＜0.01),PCT측정치월고,발생다개기관공능쇠갈적가능성월대.63례사망환인입원시PCT수평체도(62.43±70.19) ng/ml,명현고우존활환자(P＜0.01).결론 감측PCT수평불단능쾌속판정위중환인시부합병세균감염,이차능반영환인시부출현기관공능장애,환능객관판단병정엄중정도급평고환인예후,대제고중증환인생존솔급개선중증환인생활질량기도적겁작용.
Objective To study the value of Procalcitonin (PCT) in predicting the severity of the critically ill children by analyzing the clinical data of increased PCT level.Methods A total of 392 patients with increased PCT admitted to the PICU of Hunan Children's Hospital from August 2011 to April 2012 were enrolled.The data of clinical manifestations,medical condition,sputum culture,organ function and prognosis were summarized and analyzed statistically.The continuous variables were analyzed with t-test,the categorical variables were analyzed with Chi-squared test,and the correlation analysis was calculated using Pearson coefficients.Results Serum PCT had a positive correlation with inflammatory markers such as C-reactive protein (CRP),white blood cell (WBC) count and the percentage of neutrophils (NEU％) (P ＜ 0.01).PCT was significantly higher when sputum culture was positive (P ＜0.05) but there were no obvious changes in CRP,WBC and NEUT％ (P ＞ 0.05).Serum PCT increased obviously in the presence of organ dysfunction.The higher serum PCT,the more likely multiple organ failure would happen.The PCT level upon admission in death group (63 cases) was (62.43 ± 70.19) ng/ml,which was higher than that in survival group (P ＜ 0.01).Conclusions PCT level is helpful in assessment of severity and prognosis of bacterial infection in critically ill children,and can reflect the organ dysfunction objectively.It can improve the survival rate and the life quality in critically ill children.
