血清降钙素原、乳酸检测对儿童重症肺炎病情早期评判的效果分析

Effects of both Serum Procalcitonin and Lactate Test on Early Evaluation of Severe Pneumonia in Children

目的分析血清降钙素原、乳酸检测对儿童重症肺炎病情早期评判的效果。方法选取86例重症肺炎患儿和65例普通肺炎患儿作为研究对象,分别作为重症组、普通组,比较重症组与普通组患儿入院第1天的血清降钙素原、乳酸水平。根据预后,将重症肺炎患儿分为存活组和死亡组,并进行急性生理和慢性健康状况Ⅱ(acute physiology and chronic healthevaluationⅡ,APACHEⅡ)评分;比较存活组和死亡组患儿不同时间点的血清降钙素原、乳酸水平,对血清降钙素原、乳酸水平分别与APACHEⅡ评分进行相关性分析。结果重症组患儿入院第1天的血清降钙素原、乳酸水平均显著高于普通组,差异具有统计学意义(P<0.05)。死亡组与存活组患儿入院第1天的血清降钙素原、乳酸水平差异均无统计学意义(P>0.05)。死亡组患儿入院第4、7天、转出或死亡前的血清降钙素原、乳酸水平均显著高于存活组,差异具有统计学意义(P<0.05)。Spearman等级相关分析可知,血清降钙素原、乳酸水平与APACHEⅡ评分均呈正相关(P<0.05)。结论动态检测血清降钙素原、乳酸水平,并分析其变化情况,对于判断重症肺炎患儿的疗效、疾病转归及预后均具有积极作用。

Objective To analyze the effect of tesing of serum procalcitonin and lactic acid on the early diagnosis of severe pneumonia in children. Methods Selected 86 cases of children with severe pneumonia and65 cases of normal children with pneumonia as the research cohort,labeled as the severe group and ordinary group; The levels of serum procalcitonin and lactate were measured on the 1st day after admission. The children with severe pneumonia were divided into survival group and death group according to the prognosis,and acute physiology and chronic health status Ⅱ The serum procalcitonin and lactate levels were compared between the survival group and the death group at different time points,and the serum procalcitonin and lactate levels were compared with the APACHEⅡscore. Results The levels of serum procalcitonin and lactate were significantly higher in the severe group than those in the normal group on day 1（P〈0. 05）. No differences were observed between the survivors and death group（P〈0. 05）. The levels of procalcitonin and lactate were significantly lower in the surviving group than those in the surviving group at the 4th,7th day and the post-death or post-death period（P〈0. 05）. The serum levels of procalcitonin and lactate were significantly lower（P〈0. 05）. Spearman rank correlation analysis show ed that serum procalcitonin and lactate level were positively correlated with APACHE Ⅱ score（P〈0. 05）. Conclusion The dynamic measurement of serum procalcitonin and lactate level and analysis of serum procalcitonin and lactic acid level may play an active role in evaluating the curative effect,prognosis and prognosis of children with severe pneumonia.