不同细菌感染所致脓毒症患儿血清降钙素原水平的研究

The level of serum procalcitonin in children with sepsis caused by different bacteria

目的探讨革兰阳性(G+)细菌与革兰阴性(G-)细菌感染所致脓毒症患儿血清降钙素原(PCT)的水平变化,为临床早期正确使用抗生素提供依据。方法检测197例脓毒症患儿的PCT、CRP水平及WBC计数,同时进行血细菌培养,将62例血培养阳性的患儿分为G+组和G-组,并对2组患儿的上述3项指标进行统计学分析。结果 G+组和G-组患儿WBC计数和血清CRP水平比较差异均无统计学意义(P>0.05)。62例脓毒症患儿血清PCT全部阳性;在PCT≥2.00ng/mL等级时,G+组患儿的百分率明显高于G-组(P<0.01);而在PCT≥10.00ng/mL等级时,G-组患儿的百分率明显高于G+组(P<0.01)。结论 G-细菌感染所致脓毒症患儿血清PCT水平高于G+细菌感染者,为临床早期选用抗生素治疗小儿脓毒症提供了参考依据。

Objective To determine the level of serum procalcitonin（PCT） in children with sepsis caused by gram-positive （G＋ ） and gram-negative（G ） bacteria and provide basis for physicians to properly use antibiotics in eraly stage. Methods The levels of PCT and CRP,WBC count and blood bacteria culture were measured in 197 cases of sepsis children. 62 cases of sepsis children with positive blood culture were divided into G ^＋ group and G group. The above three indexes were compared between the two groups. Results The differences of CRP level and WBC count were both not significant between the two groups（P2〉0.05）. Serum PCT levels were all abnormal in 62 cases of sepsis children. In the grade of PCT≥2.00 ng/mL,the positive rate of G＋ group was significantly higher than that of G group （P〈0.01）. But inthe grade of PCT≥10.00 ng/mL,the positive rate of G group was significantly higher than that of G＋ group（P〈0.01）. Conclusion The levels of PCT in sepsis children caused by gram-negative bacteria is higher than that caused by gram-positive bacteria,and this provides basis for physicians to properly use antibiotics in early stage.