血清降钙素原在各种肺炎患儿鉴别诊断与治疗中的临床价值

Clinical value of serum procalcitonin in the differential diagnosis and treatment of children with different kinds of pneumonia

目的探讨血清降钙素原(PCT)在各种肺炎患儿鉴别诊断与治疗中的临床价值。方法 85例肺炎患儿根据病原体分为细菌性肺炎32例(A组)、病毒性肺炎28例(B组)和支原体肺炎25例(C组),细菌性肺炎患儿根据治疗情况分为好转组(20例)和未好转组(12例)。观察A、B、C三组PCT阳性率及血清PCT表达水平,观察好转组与未好转组在使用抗生素治疗第1、4、7d时血清PCT表达水平。结果 A组PCT阳性率(90.6%)及表达水平(1.96±1.24)ng/m L明显高于B组(7.1%,0.21±0.11 ng/m L)和C组(32.0%,0.34±0.15 ng/m L);好转组患儿使用抗生素治疗第4d血清PCT表达水平较第1d明显下降(P<0.05),而未好转组血清PCT表达水平无明显降低(P>0.05),经调整治疗方案后,未好转组第7d血清PCT表达水平较第4d明显降低(P<0.05)。结论血清PCT水平检测对各种肺炎患儿具有较高的鉴别诊断价值,还可评估抗生素治疗的临床效果。

Objective To investigate the clinical value of serum procalcitonin （PCT） in the differential diagnosis and treatment of children with different kinds of pneumonia. Methods 85 children with bacterial pneumonia were divided into three groups according to the pathogens, which included 32 eases of bacterial pneumonia （ the group A ）, 28 cases of viral pneumonia （ the group B）, and 25 cases of mycoplasma pneumonia （ the group C）. The group A was further divided into the improved group （20 cases） and the non-improved group （12 eases） according to the treatment condition. The positive rate of PCT and the serum PCT expression levels in the A, B, C groups were observed respectively. The expression levels of serum PCT in the improvement group and the non-improved group were observed at the 1st, 4th and 7th days of antibiotics treatment. Results The positive rate of PCT （90. 6% ） and its expression level （ 1.96 ± 1.24 ng/mL） were significantly higher in the group A than those in the group B （7.1%, 0. 21 ±0. 11 ng/mL） and the group C （32.0%, 0. 34 ±0. 15 ng/mL）. The expression level of serum PCT in the improved group 4 days after antibiotics treatment decreased significantly than 1 day after antibiotics treatment （ P 〈 0. 05 ）, while the expression level of serum PCT were not significantly lower in the non-improved group （ P 〉 0. 05 ）. After adjusting treatment programs, the expression level of serum PCT decreased significantly 7 days after the treatment （P 〈 0. 05 ）. Conclusion The serum PCT level has high diagnostic value for bacterial pneumonia, and it can assess the clinical effectiveness of antibiotic treatment.