脓毒症危重患儿血清降钙素原水平变化及临床意义

Changes of serum procalcitonin in children with severe sepsis and its clinical significance

目的探析脓毒症危重患儿血清降钙素原(PCT)水平的变化及临床意义。方法选取湖南省儿童医院急诊综合二科2015年6月至2016年6月收治的150例脓毒症患儿,其中75例危重患儿作为严重脓毒症组,75例脓毒症非危重患儿为脓毒症组,并以同期75例健康体检儿童为健康对照组。严重脓毒症组及脓毒症组均接受常规治疗,比较3组血清PCT、D-二聚体、C-反应蛋白(CRP)。结果治疗前,严重脓毒症组与脓毒症组血清PCT、D-二聚体、CRP均分别高于健康对照组,且严重脓毒症组较脓毒症组血清指标明显升高[PCT(mg/L):7 875.50±5.75比3 569.88±5.82,D-二聚体(mg/L):3.75±0.35比1.66±0.34,CRP(mg/L):88.41±1.19比63.24±1.20,均P<0.05]。治疗后,严重脓毒症组和脓毒症组血清PCT、D-二聚体、CRP均较治疗前明显降低[严重脓毒症组:PCT(mg/L)为1 700.39±5.64比7 875.50±5.75,D-二聚体(mg/L)为0.93±0.28比3.75±0.35,CRP(mg/L)为48.80±1.07比88.41±1.19;脓毒症组:PCT(mg/L)为1 690.64±5.50比3 569.88±5.82,D-二聚体(mg/L)为0.90±0.22比1.66±0.34,CRP(mg/L)为48.72±1.08比63.24±1.20,均P<0.05],且两组治疗后结果与健康对照组比较差异无统计学意义(均P>0.05)。结论血清PCT可准确反映脓毒症危重患儿的病情变化情况,并可作为临床疗效判定指标,值得在临床诊疗工作中推广使用。

Objective To investigate the changes and clinical significance of serum procalcitonin（PCT） in children with severe sepsis.Methods 150 children with sepsis were enrolled from June 2015 to June 2016 in Children＇s Hospital of Hunan Province.75 cases of critically ill children as severe sepsis group,75 cases of sepsis non-critically ill children as sepsis group,and the same period,75 cases of healthy children as a healthy control group,sepsis group and severe sepsis group were given routine treatment.Serum PCT,D-Dimer and CRP were compared among the three groups.Results Before treatment,the serum indexes of severe sepsis group and sepsis group were higher than that of healthy control group.And serum levels of severe sepsis patients were significantly higher than those of sepsis patients [PCT（mg/L）：7 875.50±5.75 vs.3 569.88±5.82,D-Dimer（mg/L）：3.75±0.3 vs.1.66±0.34,CRP（mg/L）：88.41±1.19 vs.63.24±1.20,all P 〈0.05].After treatment,the levels of PCT,D-dimer,CRP levels were significantly lower than those before treatment in severe sepsis and sepsis group [Severe sepsis group：PCT（mg/L）：1 700.39±5.64 vs.7 875.50±5.75,D-dimer（mg/L）：0.93±0.28 vs.3.75±0.35,CRP（mg/L）：48.80±1.07 vs.88.41±1.19.Sepsis group：PCT（mg/L）：1 690.64±5.50 vs.3 569.88±5.82,D-Dimer（mg/L）：0.90±0.22 vs.1.66±0.34,CRP（mg/L）：48.72±1.08 vs.63.24±1.20,all P〈 0.05].There was no significant difference between the two groups and healthy control group（all P 〉0.05）.Conclusions Serum PCT can accurately reflect the change of illness in critically ill children with sepsis and can be used as an index to judge the clinical efficacy.It is worth to be used in clinical diagnosis and treatment.