降钙素原检测在新生儿坏死性小肠结肠炎中的临床价值

Clinical value of procalcitonin detection in neonatal necrotizing enterocolitis

目的探讨降钙素原检测在新生儿坏死性小肠结肠炎（NEC）中的临床价值。方法将符合条件的60例NEC病例随机分成观察组和对照组，又按NEC分级为Ⅰ级组（19例），Ⅱ-Ⅲ级组（41例）、所有病例均在确诊后进行降钙素原（PCT）检测。观察组根据PCT水平使用抗生素，对照组根据治疗常规及经治医师的临床经验使用抗生素。结果60例NEC病例中仅28例（46．7％）出现PCT升高。在NEC患儿Ⅰ、Ⅱ-Ⅲ级组中，PCT升高的比例分别为26．3％、56．1％，PCT阳性病例的PCTmax分别为（0．81±0．25）、（1．76±89）μg／L，差异均有统计学意义（χ24．627，t=-2．608，P均〈0．05）。观察组抗生素的使用时间显著少于对照组[（4．9±3．0）d与（8．6±2．5）d，t=-3．645，P〈0．01]，而两组的禁食时间及治愈时间差异均无统计学意义（P均〉0．05）。结论PCT检测可帮助了解NEC患儿的病因及疾病的严重程度；根据PCT水平使用抗生素可减少抗生素使用时间而不影响NEC治疗效果。

Objective To investigate the clinical value of of procalcitonin detection in neonatal necrotizing enterocolitis （NEC） . Methods Sixty cases eligible NEC infants were randomly divided into observation group and control group（ n= 30 each group） . All the infants were divided into Ⅰ grade group （19 cases） ,Ⅱ- Ⅲgrade group（41 cases） according to NEC classification. All infants received PCT detection after NEC diagnosis. The observation group received antibiotic treatment base on the serum PCT levels. The control group received antibiotic treatment according to treatment routine and physician＇s clinical experience. Results PCT increased in 28 （46. 7%） of the 60 NEC infants. In the Ⅰ grade group and Ⅱ- Ⅲgrade group, the proportion of PCT increased cases were 26. 3% ,61.3% respectively, and the PCTmax in PCT positive cases were （0. 81 ±0. 25） μg/L, （ 1.76±0. 89） μg/L respectively, the differences were signifiacnt （ χ2 = 4. 627, t = -2. 608, P〈0. 05） . The time of antibiotic usage in observation group was significantly less than that in control group （ （4. 9± 3.0） d vs. （8. 6± 2. 5） d, t =- 3. 645, P〈 0. 01 ） . The fasting time and the cure time of the two groups had no significant difference （P〉 0. 05） . Conclusion PCT detection can help to understand the cause and severity of NEC. Using antibiotics according to PCT levels can reduce the time of antibiotic usage without affecting the effect of the NEC treatment.