降钙素原在鉴别脓毒症患儿细菌感染类别的临床意义

Clinical Significance of Procalitonin in Discriminating Gram-negative and Grampositive Bacterial Infection in Children with Sepsis

目的探讨降钙素原(PCT)定量检测判断脓毒症患儿革兰阴性菌(GN)感染及革兰阳性菌(GP)感染的临床价值。方法回顾性分析2011年12月-2012年4月湖南省儿童医院所有诊断为脓毒症的住院患儿的病历资料,比较GN感染患儿及GP感染患儿PCT水平,根据ROC曲线判断PCT的诊断性能。结果共83例脓毒症患儿纳入研究,GN感染者住院时间较GP感染者短、PCT水平较GP感染者高,PCT区分GN及GP的敏感性、特异性、准确度分别为78.6%、81.5%、79.5%,ROC曲线下面积为0.801。结论 PCT对区分脓毒症患儿革兰阴性菌及革兰阳性菌感染具有一定的临床价值,可辅助指导临床早期合理应用抗生素。

Objective To explore the significance of serum procalitonin （PCT） quantitative detection in discriminating gram-negative （GIN） and gram positive（GP） bacterial infection in children with sepsis. Methods Retrospective analysis was made on the patient histories of all the children with sepsis hospitalized in Hunan Children＇ s Hospital between December, 2011 and April, 2012. The serum PCT level was determined and compared between children with GN bacterial infection （GN Group） and those with GP bacterial infection （GP Group）. The diagnc^stic performance of PCT was determined by ROC curve. Results Totally, 83 children with sepsis were recruited. The hospitalization time of the GN group was shorter than that of the GP group, while the serum PCT level was higher in the GN group than in the GP group. The sensitivity, specificity and ac- curacy of PCT in discriminating GN and GP bacterial infection in children with sepsis were 78.6%, 81.5% and 79.5%, respec- tively. The area under the ROC curve was 0. 801. Conclusions PCT is of clinical significance in discriminating GN and GP bacteria as causative pathogens of children with sepsis. It may be helpful for early and reasonable selection of antibiotics.