婴幼儿重症肺炎血PCT及乳酸监测的临床意义

The Clinical Significance of Dynamic Monitoring Blood Procalcitonin and Lactic Acid in Infants andYoung Children with Serious Pneumonia

目的:探讨动态监测血降钙素原(PCT)及动脉血乳酸在婴幼儿重症肺炎中的临床意义。方法:选取重症肺炎患儿60例,其中细菌性肺炎组38例,非细菌性肺炎组22例,同时选取30例健康体检儿童作为对照组,检测肺炎患儿治疗前后血PCT值。根据预后情况将重症肺炎患儿分为有效组和无效组,分析比较两组患儿入院时动脉血乳酸值及12、24 h乳酸清除率。结果:入院时细菌性肺炎组血PCT值显著高于非细菌性肺炎组及对照组,比较差异均有统计学意义(P<0.05);治疗3 d后细菌性肺炎组血PCT值较治疗前明显下降,治疗前后比较差异有统计学意义(P<0.05)。入院时细菌性肺炎组及非细菌性肺炎组患儿动脉血乳酸值显著高于对照组,比较差异均有统计学意义(P<0.05);有效组与无效组入院时动脉血乳酸值比较差异无统计学意义(P>0.05),但有效组12、24 h乳酸清除率明显高于无效组,比较差异均有统计学意义(P<0.05)。结论:血PCT及动脉血乳酸在婴幼儿重症肺炎的鉴别诊断、评估病情严重程度及预后、监测治疗效果等方面有较高的临床价值。

Objective： To analyze the clinical significance of dynamic monitoring blood PCT （ procalcitonin ） and lactic acid in infants and young children with serious pneumonia.Method： A total of 60 children with severe pneumonia were enrolled in the study, they were divided into bacterial pneumonia group with 38 cases and nonbacterial pneumonia group with 22 cases.And 30 healthy children were selected as control group.The value of PCT in children with pneumonia were detected before and after treatment. According to the prognosis of patients with severe pneumonia were divided into effective group and ineffective group, the arterial blood lactate, 12 and 24 h lactate clearance rate of two groups were analyzed and compared.Result： Initial PCT level of bacterial pneumonia group was significantly higher than that of nonbacterial pneumonia and cotrol group, the differences were statistically Significant （ P〈0.05 ） .After 3 d treatment, the blood PCT value of bacterial pneumonia group was significantly decreased compared with before treatment, the difference was statistically significant （ P〈0.05 ） .The arterial blood lactic acid value of bacterial pneumonia group and non bacterial pneumonia group were significantly higher than that in control group, the differences were statistically significant （ P〈0.05 ） .There was no significant difference in the initial lactic acid level between the effective group and the ineffective group （ P〉0.05 ）, but the 12 and 24 hours lactate clearance rates in effective group were significantly higher than ineffective group, the differences were statistically significant （P〈0.05） .Conclusion： The dynamic monitoring levels of blood PCT and lactic acid in infants and young children with serious pneumonia are the favorable indicators for differential diagnosing, condition judgment , evaluation oftherapeutic efficiency and prognosis.