降钙素原、乳酸、D-二聚体水平与脓毒血症患儿病情的关系

Relationship between serum biomarkers of procalcitonin,lactate,D-dimer and disease severity in sepsis children

目的探讨血降钙素原(PCT)、乳酸和D-二聚体3种生物标记物评估脓毒血症患儿病情严重程度及预后的临床价值。方法收集2008年1月至2013年1月86例脓毒血症患儿的临床资料,将其按病情严重程度分为早期脓毒症组、严重脓毒症组和脓毒症休克组;回顾性研究则将所有患儿根据预后分为生存组及死亡组。分别比较各组患儿血降钙素原、乳酸、D-二聚体水平和小儿危重病例评分(PCIS),观察血降钙素原、乳酸、D-二聚体3种标记物水平评估病情严重程度及预后的临床价值。结果不同严重程度的脓毒血症的3组患儿中,3种标记物水平及PCIS比较差异均有统计学意义(P<0.05)。生存组患儿血降钙素原、乳酸、D-二聚体水平和PCIS与死亡组比较差异均有统计学意义(P<0.05),且呈负相关关系。结论血降钙素原、乳酸、D-二聚体水平对小儿脓毒血症病情严重程度与预后判断具有指导意义,患儿血降钙素原、乳酸、D-二聚体水平越高,PCIS越低,病情越重,预后越差。

Objective To explore the relationship between serum biomarkers of procalcitonin （PCT）,lactate,D-dimer and disease severity in sepsis children.Methods 86 cases of sepsis were reviewed from January 2008 to January 2013.86 cases of sepsis were classified as early sepsis group,severe sepsis group and septic shock group.Patients were divided into survival group and death group according to their outcome.Serum biomarkers of PCT,lactate and D-dimer were measured and were analyzed their correlation with the prognosis of critically ill children according to pediatric critical illness score （PCIS）.Results There were significantly difference on the level of three biomarkers in early sepsis group,severe sepsis group and septic shock group （P＆lt;0.05）.There were significantly negative correction on the survival group and death group with PCIS （P＆lt;0.05）.Conclusions The joint detection of serum biomarkers of PCT,lactate and D-dimer has guiding significance in the early diagnosis for children sepsis.Children with higher PCT,lactate and D-dimerin levels and lower PCIS were worse and had poorer prognosis.