血清降钙素原检测在儿童下呼吸道感染病原诊断中的价值

Detection value of serum procalcitonin in the pathogen diagnosis of children with lower respiratory tract infection

目的探讨血清降钙素原(PCT)检测在儿童下呼吸道感染病因学诊断中的价值。方法回顾性分析疑似下呼吸道感染的1 873例儿童患者送检的首次痰培养及PCT检测结果,比较患者痰培养结果与血清PCT水平的关系,分析革兰阴性菌、革兰阳性菌及真菌感染后患者体内PCT水平的差异。结果以0.5μg/L为血清PCT阳性阈值。痰培养病原菌阳性率为30.1%,血清PCT阳性率为35.6%。病原菌培养阳性患儿血清PCT检测值和PCT阳性率均明显高于细菌培养阴性患儿和正常菌群患儿,差异均有统计学意义(P<0.01);革兰阴性菌或革兰阳性菌单独感染、混合感染和真菌感染血清PCT阳性率差异无统计学意义(P>0.05)。结论血清PCT检测可作为呼吸道感染病因检测的重要指标,用于指导临床抗生素的使用。

Objective To explore the detection value of procalcitonin（PCT） in pathogenic diagnosis of children with lower respiratory tract infection.Methods The first results of PCT and sputum culture from suspected children patients with lower respiratory tract infection were conducted for retrospective analysis.The relationship between sputum culture and PCT concentrations was compared,and the PCT levels in patients respectively infected with gram-negative bacteria,gram-positive bacteria and Fungi.Results The threshold of PCT concentration was set as 0.5 μg/L.The positive ratios of sputum culture results and procalcitonin were respectively 30.1% and 35.6%.The PCT levels and positive rates in patients with positive sputum culture results were higher than that of sputum culture-negative patients and sputum normal patients,and the differences were statistically significant（P〈 0.01）.The positive rates of PCT were not statistically significant in the differences among single infection of gram-positive bacteria or gram-negative bacteria,the mixed infection,and fungal infection（P 〉0.05）.Conclusion Serum procalcitonin level can be one of the important indicators to the diagnosis of lower respiratory tract infection,which can guide the clinical use of antibiotics.