国际儿科学杂志
國際兒科學雜誌
국제인과학잡지
INTERNATIONAL JOURNAL OF PEDIATRICS
2015年
2期
218-221
,共4页
感染%降钙素原%小儿危重症评分%细菌耐药
感染%降鈣素原%小兒危重癥評分%細菌耐藥
감염%강개소원%소인위중증평분%세균내약
Infection%Procalcitonin%Pediatric critical illness score%Bacterial resistance
目的 了解降钙素原(procalcitonin,PCT)与儿童感染性疾病致病原及与病情危重程度的关系.方法 该研究为感染性疾病患儿血清降钙素原的单中心前瞻性研究.选择2011年4月至2013年4月盛京医院PICU感染性疾病患儿95例,并根据病原体分为3组(肺炎支原体感染组30例,病毒感染组30例,细菌感染组35例);不同病原组依据简化小儿危重症评分分为3组(非危重组、危重组、极危重组);将细菌感染组患儿分为革兰阳性菌组(20例)、革兰阴性菌组(15例);选择同期非感染性疾病儿童20例作为对照组.血清PCT在盛京医院检验科统一检测,应用VIDAS BRAHMS PCT法检测.结果 对照组、细菌感染组、病毒感染组、支原体感染组的血清PCT浓度分别为(0.41±n 34) μg/L、(2.56±0.38) μg/L、(0.52±0.44) μg/L、(0.21 ±0.10) μg/L.PCT≥0.5 μg/L作为阳性界值.细菌感染组PCT阳性率与对照组比较差异有显著性(x2=28.05,P＜0.05).细菌感染组患儿血清PCT浓度高于肺炎支原体感染组、病毒感染组及对照组(P＜0.05);细菌感染组中,革兰阴性菌组血清PCT浓度明显高于革兰阳性菌组(P＜0.05).肺炎支原体感染组、病毒感染组血清PCT浓度与对照组比较差异无统计学意义(P＞0.05).患儿血清PCT浓度与简化小儿危重症评分呈显著负相关(r=-0.579～-0.793,P＜0.05).PCT浓度越高的患儿病情越重,相关并发症越多,住院时间越长.结论 PCT可作为鉴别细菌感染与肺炎支原体感染、病毒感染的敏感指标.在感染的早期诊断中,PCT可反映病情的严重程度.
目的 瞭解降鈣素原(procalcitonin,PCT)與兒童感染性疾病緻病原及與病情危重程度的關繫.方法 該研究為感染性疾病患兒血清降鈣素原的單中心前瞻性研究.選擇2011年4月至2013年4月盛京醫院PICU感染性疾病患兒95例,併根據病原體分為3組(肺炎支原體感染組30例,病毒感染組30例,細菌感染組35例);不同病原組依據簡化小兒危重癥評分分為3組(非危重組、危重組、極危重組);將細菌感染組患兒分為革蘭暘性菌組(20例)、革蘭陰性菌組(15例);選擇同期非感染性疾病兒童20例作為對照組.血清PCT在盛京醫院檢驗科統一檢測,應用VIDAS BRAHMS PCT法檢測.結果 對照組、細菌感染組、病毒感染組、支原體感染組的血清PCT濃度分彆為(0.41±n 34) μg/L、(2.56±0.38) μg/L、(0.52±0.44) μg/L、(0.21 ±0.10) μg/L.PCT≥0.5 μg/L作為暘性界值.細菌感染組PCT暘性率與對照組比較差異有顯著性(x2=28.05,P＜0.05).細菌感染組患兒血清PCT濃度高于肺炎支原體感染組、病毒感染組及對照組(P＜0.05);細菌感染組中,革蘭陰性菌組血清PCT濃度明顯高于革蘭暘性菌組(P＜0.05).肺炎支原體感染組、病毒感染組血清PCT濃度與對照組比較差異無統計學意義(P＞0.05).患兒血清PCT濃度與簡化小兒危重癥評分呈顯著負相關(r=-0.579～-0.793,P＜0.05).PCT濃度越高的患兒病情越重,相關併髮癥越多,住院時間越長.結論 PCT可作為鑒彆細菌感染與肺炎支原體感染、病毒感染的敏感指標.在感染的早期診斷中,PCT可反映病情的嚴重程度.
목적 료해강개소원(procalcitonin,PCT)여인동감염성질병치병원급여병정위중정도적관계.방법 해연구위감염성질병환인혈청강개소원적단중심전첨성연구.선택2011년4월지2013년4월성경의원PICU감염성질병환인95례,병근거병원체분위3조(폐염지원체감염조30례,병독감염조30례,세균감염조35례);불동병원조의거간화소인위중증평분분위3조(비위중조、위중조、겁위중조);장세균감염조환인분위혁란양성균조(20례)、혁란음성균조(15례);선택동기비감염성질병인동20례작위대조조.혈청PCT재성경의원검험과통일검측,응용VIDAS BRAHMS PCT법검측.결과 대조조、세균감염조、병독감염조、지원체감염조적혈청PCT농도분별위(0.41±n 34) μg/L、(2.56±0.38) μg/L、(0.52±0.44) μg/L、(0.21 ±0.10) μg/L.PCT≥0.5 μg/L작위양성계치.세균감염조PCT양성솔여대조조비교차이유현저성(x2=28.05,P＜0.05).세균감염조환인혈청PCT농도고우폐염지원체감염조、병독감염조급대조조(P＜0.05);세균감염조중,혁란음성균조혈청PCT농도명현고우혁란양성균조(P＜0.05).폐염지원체감염조、병독감염조혈청PCT농도여대조조비교차이무통계학의의(P＞0.05).환인혈청PCT농도여간화소인위중증평분정현저부상관(r=-0.579～-0.793,P＜0.05).PCT농도월고적환인병정월중,상관병발증월다,주원시간월장.결론 PCT가작위감별세균감염여폐염지원체감염、병독감염적민감지표.재감염적조기진단중,PCT가반영병정적엄중정도.
Objective To explore the change of serum procalcitonin (PCT)in infectious diseases and the relationship between PCT and the severity of illness in children.Methods This was a single-center prospective study of serum procalcitonin concentration in children with infectious diseases.Ninty-five children with infectious diseases (mycoplasma infection 30 cases,viral infection 30 cases,bacterial infection 35 cases),hospitalized in PICU of Shengjing Hospital from April 2011 to April 2013,were divided into three groups:non-serious group(64 cases),serious group(20 cases)and very serious group(11 cases)according to pediatric critical illness score(PCIS).Bacterial infectious patients were divided into two groups:gram positive bacterial group(20cases),gram negative bacterial group(15 cases).Twenty children of non-infectious diseases during the same period were selected as the control group.Serum PCT levels were detected by using VIDAS BRAHMS PCT detection system(rapid semi-quantitative PCT test).Laboratory detection was conducted in Department of Laboratory Medicine,Shengjing Hospital of China Medical University.Results The serum PCT levels of the control,the bacterial infection,virus infection,and mycoplasma infection group were (0.41 ± 0.34) μg/L,(2.56 ± 0.38)μg/L,(0.52 ±0.44) μg/L and(0.21 ±0.10) μg/L.The serun PCT levels higher than or equal to 0.5 μg/L were defirned as positive.There was significant difference in PCT positive rate between bacterial infection group and the control grouP(x2 =28.05,P ＜0.05).The serum PCT levels of children with infectious diseases were higher than those of non-infection group,mycoplasma infection group and virus infection group(P ＜ 0.05).Besides,the PCT value of gram negative bacillus infection group was also obvious higher than gram positive infection group.There was no significant difference among the non-infection group,mycoplasma infection group and virus infection group(P ＞ 0.05).There was significant negative correlation between the serum PCT concentration and the PCIS score in children with infectious diseases (r =-0.579 ～-0.793,P ＜ 0.05).The higher concentration of PCT in children with the infectious diseases indicated higher severity illness scores,more complications,and longer length of hospital stay.Conclusions PCT may provide an informative and sensitive molecular marker for pathogen identification (bacterial infection,pneumonia mycoplasma infection or viral infection).In the early diagnosis of infectious disease,PCT assay can help predict the severity of the disease.
