联合检测血清降钙素原、血清前白蛋白和视黄醇结合蛋白对脓毒血症早期诊断的价值

The value of combined detection of serum precalcitonin,prealbumin and retinol-binding protein in the early diagnosis of sepsis

目的探讨降钙素原(PCT)对脓毒血症的诊断意义,血清前白蛋白(PA)与视黄醇结合蛋白(RBP)对脓毒血症患儿的肝、肾功能损害的早期预测意义。方法收集2018年1月至2019年8月于浙江省台州医院治疗的脓毒血症患儿150例(脓毒血症组)、普通感染儿童150例(普通感染组)和门诊同期体检的正常儿童150例(正常对照组)。收集三组研究对象的基本数据和血标本,分别检测血常规、C反应蛋白(CRP)、PCT、生化全套,对相关数据进行统计分析。结果脓毒血症组患儿PCT水平明显高于普通感染组和正常对照组,PA、RBP水平明显低于普通感染组和正常对照组,差异有统计学意义[PCT:(7.02±5.26)μg/L比(0.37±0.28)、(0.03±0.01)μg/L;PA:(9.31±4.36)mg/dl比(31.05±5.05)、(33.56±4.59)mg/dl;RBP:(9.26±3.58)mg/L比(31.2±5.89)、(33.83±6.31)mg/L](P<0.05);普通感染组和正常对照组患儿的PA及RBP水平比较差异无统计学意义(P>0.05)。三组患儿的丙氨酸氨基转移酶、天冬氨酸氨基转移酶、白蛋白、尿素氮及肌酐水平均在正常范围,差异无统计学意义(P>0.05)。结论联合检测血清PCT、PA、RBP对脓毒血症更有诊断意义,能早期发现肝、肾功能损害。

Objective To investigate the clinical diagnosis value of serum precalcitonin(PCT)and early predictive significance of prealbumin(PA)and retinol-binding protein(RBP)in liver and renal injury for sepsis in children.Methods One hundred and fifty sepsis children were enrolled from the ward of children in Taizhou Hospital of Zhejiang Province from January 2018 to August 2019.In the same period 150 children with common infection and 150 healthy children who underwent physical examination were included into the study.According to the test,basic data was collected,and biochemical examinations,including the concentrations of the liver function,renal function,PA and RBP were measured.Then the data in the three groups was analyzed.Results The levels of PCT in sepsis group were significantly higher than those in the common infection group and the normal group:(7.02±5.26)μg/L vs.(0.37±0.28),(0.03±0.01)μg/L;the levels of PA and RBP in sepsis group were significantly lower than those of the other two groups:(9.31±4.36)mg/dl vs.(31.05±5.05),(33.56±4.59)mg/dl;(9.26±3.58)mg/L vs.(31.2±5.89),(33.83±6.31)mg/L,and there were significant statistical differences(P<0.05).The levels of PA and RBP in the common infection group and the normal group were normal and there was no difference between the two groups(P>0.05).There were no significant statistical differences in other indicators such as alanine aminotransferase,asparagus cochinchinensis,albumin,urea nitrogen and creatinine(P>0.05).Conclusions Combined detection of serum PCT,PA and RBP plays an important role in the early diagnosis of children′s sepsis.