血清前降钙素对儿科脓毒症的早期诊断作用(1)
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2010年3月5日
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[摘要] 目的:与其他常用临床指标相比,评价血清前降钙素对于儿童脓毒症的早期诊断价值。方法:随机选取2008年1～12月在PICU治疗的患儿37例,根据ACCP/SCM会议的诊断标准,将患儿分为三组,脓毒症组,非感染组,病毒感染组,于入院第1天对患儿进行血清前降钙素水平测定,并测定体温、血清CRP、外周血白细胞计数。结果:脓毒症组患儿有较高的血清前降钙素(PCT)水平,而其他临床指标:体温、外周血白细胞计数在组间无显著差别,血清CRP在三组间有数据重叠。结论:与常规指标相比(体温、血清CRP、外周血白细胞计数),脓毒症患儿血清PCT水平明显升高,因而,血清PCT可以用于早期诊断严重感染和脓毒症。
[关键词] 前降钙素(PCT);脓毒症;ACCP/SCM会议
[中图分类号] R446.11 [文献标识码]A [文章编号]1674-4721(2010)03(a)-031-02
The early diagnosis value of serum procalcitonin to children′s sepsis
CAO Mei
(Department of children′s emergency, Wuxi People′s Hospital, Wuxi 214023, China)
[Abstract] Objective: Compared with other clinical index,evaluated the early diagnosis value of serum procalcitonin to children′s sepsis. Methods: Randomly selecting 37 cases of children who entered into PICU treatment from January to December 2008. According to the diagnostic criteria of ACCP/SCM Conference, these children were divided into three groups,sepsis group, non-infected group and virus infection group. They were tested serum procalcitonin levels, measured body temperature,serum CRP, peripheral blood white blood cell count individually on the first day of hospitalization. Results: Group of children with sepsis had higher levels of serum PCT, while there were no differences in other clinical indicators such as body temperature, peripheral white blood cell count.And serum CRP data had overlapped phenomenon among the three groups. Conclusion: Compared with conventional indicators(body temperature,CRP,peripheral blood white blood cell count),serum PCT levels in children with sepsis is significantly increased, hence, serum PCT can be used for early diagnosis of severe infection and sepsis.
[Key words] Procalcitonin(PCT);Sepsis;ACCP/SCM Conference
脓毒症导致多脏器功能衰竭患者死亡率可达30%～70%,但是只通过临床表现早期诊断感染往往非常困难。在细菌学检查方面,常规实验室检查对严重感染的诊断极为重要,以便于及时判断病情、确定治疗方案、判定预后。临床需要有一种鉴定炎症的标志物,且具有高度的特异性和敏感性,在疾病早期即可做出诊断,并与感染的严重性呈相关性。本研究目的旨在通过检测脓毒症患儿的血清前降钙素水平,并和其他常规指标相比,探讨其在儿科脓毒症诊断中的应用价值。
1 资料与方法
1.1 临床资料
2008年1～12月无锡市人民医院儿童重症监护病房(PICU)收治的 37例患儿,男23例,女14例,平均年龄1.8岁,根据临床诊断,分为非感染组12例,脓毒症组11例,病毒感染组14例。脓毒症组,原发病:肺炎7例,腹膜炎3例,化脓性脑膜炎1例,其中血培养阳性8例 ......
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