动态监测C-反应蛋白、降钙素原、白细胞计数和肾上腺髓质素前体对预测重症监护病房患儿医院感染的价值研究

Values of dynamic monitoring of C-reactive protein,procalcitonin,white blood cell count and pro-adrenomedullin in predicting nosocomial infection of children patients in PICU

目的探讨动态监测C-反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)和肾上腺髓质素前体(proADM)对预测重症监护病房患儿医院感染的价值研究,为临床治疗提供参考依据。方法选取2014年12月-2015年12月医院儿童重症监护室所收治的存在医院感染临床表现的患儿62例,按医院感染诊断标准分为感染组26例和高危组36例,另选同期收治无感染症状的患儿50例作为对照组;比较3组患儿临床指标。结果入住重症监护室48h后和96h后,与对照组患儿相比,感染组和高危组患儿CRP、PCT、WBC以及pro-ADM水平均显著提高,差异均有统计学意义(P<0.05)。结论入住重症监护室48h后患儿发生医院感染的概率较高,且联合检测CRP、PCT、WBC以及pro-ADM水平对医院感染的预测具有较高的参考价值。

OBJECTIVE To investigate the values of dynamic monitoring of C-reactive protein,procalcitonin,white blood cell count and pro-adrenomedullin in predicting nosocomial infection of children patients in PICU.METHODS From Dec.2014 to Dec.2015,62 children patients with clinical manifestations of infection were selected in PICU of our hospital.Totally 26 children patients were met the diagnostic criteria of nosocomial infection as infection group,and 36 children patients were not met the diagnostic criteria of nosocomial infection as high-risk group.During the same period,50 children patients with no symptoms of infection were selected as control group.The clinical indexes of the children patients in the three groups were compared and analyzed.RESULTS After 48 h and 96 hin PICU,compared with control group,the levels of CRP,PCT,WBC and pro-ADM of children patients in infection group and high-risk group were increased significantly（P〈0.05）.CONCLUSIONAfter 48 hin PICU,the children patients have the higher risk for hospital infection.Combined detection of CRP,PCT,WBC and proADM levels has high reference values for the prediction of hospital infection.