中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
6期
9-12
,共4页
危重病%感染%降钙素原%D-二聚体
危重病%感染%降鈣素原%D-二聚體
위중병%감염%강개소원%D-이취체
Critical illness%Infection%Procalcitonin%D-dimer
目的 探讨血清降钙素原(PCT)和血浆D-二聚体(D-D)水平检测在早期诊断小儿危重症感染中的临床价值.方法 采用固相免疫色谱法和免疫比浊法检测302例危重症患儿血清PCT、血浆D-D、血浆C反应蛋白(CRP)及WBC计数.结果 临床感染组(208例)患儿血清PCT阳性率和血浆D-D水平分别为96.6％(201/208)、(1.65±0.73) mg/L,均显著高于临床非感染组(94例)的10.6％(10/94)、(0.45±0.21)mg/L,差异有统计学意义(P＜0.05),而WBC计数和血浆CRP水平比较差异无统计学意义(P＞0.05).血清PCT水平和血浆D-D水平均与患儿的病情严重程度呈正相关(P＜0.05).结论 血清PCT和血浆D-D水平检测可作为早期诊断危重症患儿感染、病情严重程度评估及疗效判断的重要敏感性指标；血浆D-D水平检测对早期判断危重症患儿感染时凝血功能异常程度与广度具有重要临床指导意义,同时为临床早期合理应用抗凝药物治疗方面提供积极有效的理论依据.
目的 探討血清降鈣素原(PCT)和血漿D-二聚體(D-D)水平檢測在早期診斷小兒危重癥感染中的臨床價值.方法 採用固相免疫色譜法和免疫比濁法檢測302例危重癥患兒血清PCT、血漿D-D、血漿C反應蛋白(CRP)及WBC計數.結果 臨床感染組(208例)患兒血清PCT暘性率和血漿D-D水平分彆為96.6％(201/208)、(1.65±0.73) mg/L,均顯著高于臨床非感染組(94例)的10.6％(10/94)、(0.45±0.21)mg/L,差異有統計學意義(P＜0.05),而WBC計數和血漿CRP水平比較差異無統計學意義(P＞0.05).血清PCT水平和血漿D-D水平均與患兒的病情嚴重程度呈正相關(P＜0.05).結論 血清PCT和血漿D-D水平檢測可作為早期診斷危重癥患兒感染、病情嚴重程度評估及療效判斷的重要敏感性指標；血漿D-D水平檢測對早期判斷危重癥患兒感染時凝血功能異常程度與廣度具有重要臨床指導意義,同時為臨床早期閤理應用抗凝藥物治療方麵提供積極有效的理論依據.
목적 탐토혈청강개소원(PCT)화혈장D-이취체(D-D)수평검측재조기진단소인위중증감염중적림상개치.방법 채용고상면역색보법화면역비탁법검측302례위중증환인혈청PCT、혈장D-D、혈장C반응단백(CRP)급WBC계수.결과 림상감염조(208례)환인혈청PCT양성솔화혈장D-D수평분별위96.6％(201/208)、(1.65±0.73) mg/L,균현저고우림상비감염조(94례)적10.6％(10/94)、(0.45±0.21)mg/L,차이유통계학의의(P＜0.05),이WBC계수화혈장CRP수평비교차이무통계학의의(P＞0.05).혈청PCT수평화혈장D-D수평균여환인적병정엄중정도정정상관(P＜0.05).결론 혈청PCT화혈장D-D수평검측가작위조기진단위중증환인감염、병정엄중정도평고급료효판단적중요민감성지표；혈장D-D수평검측대조기판단위중증환인감염시응혈공능이상정도여엄도구유중요림상지도의의,동시위림상조기합리응용항응약물치료방면제공적겁유효적이론의거.
Objective To investigate the clinical value of the detection of serum procalcitonin (PCT) and plasma D-dimer (D-D) levels in the early diagnosis of infection in critically ill children.Methods Solid-phase immune chromatography and immune nephelometry were used to determine the levels of serum PCT,plasma D-D,plasma C reactive protein (CRP) and WBC count in 302 critically ill children.Results The positive rate of serum PCT and the level of plasma D-D in the infected group (208 children) were significantly higher than those in the non-infected group (94 children)[96.6％(201/208) vs.10.6％(10/94),(1.65 ± 0.73) mg/L vs.(0.45 ± 0.21) mg/L,P ＜ 0.05].But there was no significant difference of plasma CRP level and WBC count between the 2 groups (P ＞0.05).The levels of serum PCT and plasma D-D were positively correlated to the severity of the illness (P ＜ 0.05).Conclusions The levels of serum PCT and plasma D-D are between important sensitivity markers for early diagnosis of critically ill children,illness severity assessment and therapeutic evaluation.The detection of plasma D-D plays an important role in early diagnosis of the degree and the width of coagulation disorder,and also provides the theoretic basis to use anticoagulation drugs for treating the critically ill children with infection.
