降鈣素原在膿毒血癥患兒早期預后預測中的應用價值

余燕紅+陳影+梁燕芬

廣東省肇慶市第二人民醫院，廣東肇慶 526040

[摘要] 目的 探討降鈣素原（PCT）在膿毒血癥患兒早期預后預測的應用價值，以期為膿毒血癥患兒疾病的診斷治療提供依據。 方法 2012年10月～2013年10月肇慶市第二人民醫院收治的膿毒血癥患兒以及同期40例非膿毒血癥患兒（非膿毒血癥組）為研究對象，其中60例膿毒血癥患兒為膿毒血癥組，根據患病性質分為細菌性膿毒血癥組（40例）、非細菌性膿毒血癥組（20例）；60例膿毒血癥患兒中治療痊愈的為存活組，死亡的為死亡組。根據新生患兒危重病例（NCIS）評分法對60例膿毒血癥患兒患病程度進行評定；檢測細菌性膿毒血癥組、非細菌性膿毒血癥組以及非膿毒血癥組患兒的血清PCT、白細胞（WBC）、C反應蛋白（CRP）水平，并對數據進行統計分析。 結果 60例膿毒血癥患兒入院治療痊愈的41例（存活組），死亡19例（死亡組）；細菌性膿毒血癥組、非細菌性濃度血癥組血清PCT水平[（11.86±5.92）、（2.14±1.33） ng/mL]和非膿毒血癥組的血清PCT水平[（0.37±0.22） ng/mL]相比，差異有統計學意義（P < 0.05），細菌性膿毒血癥血清PCT水平與非細菌性膿毒血癥組相比，差異有統計學意義（P < 0.05）；膿毒血癥組WBC水平[（13.7±1.5）×109/L]和非膿毒血癥組患兒WBC水平分[（12.9±1.9）×109/L]相比，差異無統計學意義（P > 0.05）。1例患兒NCIS評分為非極危重，其血清PCT水平則超過14.86 ng/mL患兒最后死亡；NCIS評分為極危重患兒6例，其血清PCT水平未超過14.86 ng/mL，治療后患兒存活。 結論 血清PCT在膿毒血癥患兒早期預后預測具有顯著的應用價值。

[關鍵詞] 降鈣素原；膿毒血癥；預后；預測；應用

[中圖分類號] R978.1 [文獻標識碼] A [文章編號] 1673-7210（2014）03（b）-0044-04

Application value of procalcitonin on early prediction of insepsis patients

YU Yanhong CHEN Ying LIANG Yanfen

The Second People's Hospital of Zhaoqing City， Guangdong Province， Zhaoqing 526040， China

[Abstract] Objective To investigate the application value of procalcitonin on early prediction of insepsis patients， in order to provide the basis for the diagnosis and treatment of disease in children with sepsis. Methods From October 2012 to October 2013， in the Second People's Hospital of Zhaoqing City， 60 cases of children with sepsis （sepsis group） and 40 cases of non-sepsis（non-sepsis group） in the same period were selected， and the 60 cases of children with sepsis were divided into bacterial sepsis group （40 cases）， non bacterial sepsis group （20 cases）； 60 cases of children cured were as survival group， and children died were as death group. According to the newborn children with critical cases （NCIS） evaluation method was to assess how sick children were. The serum PCT， the WBC and CRP levels of three groups （bacterial sepsis group， non bacterial sepsis group and non sepsis group） were detected， and these date were statistical analyzed. Results 60 cases of children with sepsis cured were 41 （survival group）， died were 19 （death group）； the serum PCT levels of bacterial sepsis group and non bacterial sepsis group [（11.86±5.92）， （2.14±1.33） ng/mL] were compared with that of non sepsis group [（0.37±0.22） ng/mL]， the differences were statistically significant （P < 0.05）； the serum PCT level of bacterial sepsis group was cmopared with that of non bacterial sepsis group， the differences were statistically significant （P < 0.05）； the WBC level of sepsis groups [（13.7±1.5） ×109/L] was compared with that of non sepsis groups [（12.9±1.9） ×109/L]， the difference was not statistically significant （P > 0.05）. 1 case with non severe sepsis NCIS score， whose the serum PCT level was more than 14.86 ng/mL， was finally died； while 6 cases with severe sepsis NCIS score， whoes the serum PCT levels were less than 14.86 ng/mL， were survival. Conclusion The serum PCT in children with sepsis early prognosis prediction has significant application value.

[Key words] Procalcitonin； Sepsis； Prognosis； Predict； Application

膿毒血癥是一種常見的疾病，由真菌或細菌侵入患兒血液，并在其中生長、繁殖產生毒素引起全身感染的病癥，是患兒常見的致死病因[1]。……