革兰阳性菌与革兰阴性菌感染所致脓毒症患儿的血清降钙素原(PCT)水平

Serum procalcitonin (PCT) levels of children with sepsis caused by Gram-positive bacteria and Gram-negative bacteria

目的探讨革兰阳性菌与革兰阴性菌感染所致脓毒症患儿的血清降钙素原(PCT)水平变化及其临床应用价值。方法对35例革兰阴性菌感染脓毒症患儿与25例革兰阳性菌感染脓毒症患儿的血清PCT水平进行观察,绘制血清PCT检测在革兰阳性菌、革兰阴性菌感染脓毒症中的Roc曲线。结果患儿血清PCT水平为0.5~2.0 ng/m L及>2.0~10.0 ng/m L时,患儿革兰阳性菌感染脓毒症发病率显著高于革兰阴性菌(P<0.05);当患儿血清PCT水平>10.0 ng/m L时,患儿革兰阴性菌感染脓毒症发病率显著高于革兰阳性菌(P<0.05)。血清PCT水平诊断革兰阳性菌或格兰阳性菌血流感染所致脓毒症的特异度和灵敏度均较高。结论血清PCT水平的变化可作为诊断脓毒症患儿格兰阴性菌或格兰阳性菌感染的依据。

Objective To discuss and analyze the the changes of serum procalcitonin（PCT） levels of children with sepsis caused by Gram-positive bacteria and Gram-negative bacteria and its clinical application value. Methods Serum PCT levels of children with sepsis caused by Gram-positive bacteria（25 cases） and Gram-negative bacteria（35 cases） were observed, and the ROC curve of PCT detection in children with sepsis caused by Gram-positive bacteria and Gram-negative bacteria were drew.Results When serum PCT levels in children were 0.5-2.0 ng/m L and 〉2.0-10.0 ng/m L, the incidences of Gram-positive bacteria infection in children were significantly higher than those of Gram-negative bacteria（P〈0.05）. When serum PCT level in children was 〉10.0 ng/m L, the incidence of Gram-negative bacteria infection in children was significantly higher than that of gram-positive bacteria（P〈0.05）. Serum PCT detection had higher specificity and sensitivity in the diagnosis of sepsis caused by Gram-positive bacterial or Gram-negative bacterial bloodstream infections. Conclusion Changes of serum PCT levels can be used as a basis of the diagnosis in children with sepsis caused by Gram-negative or Gram-positive infections.