PCT在新生儿呼吸机相关性肺炎中的表达及临床意义

Expression and clinical significance of PCT in neonatal ventilator associated pneumonia

目的探讨降钙素原(PCT)在新生儿呼吸机相关性肺炎(VAP)中的表达及临床意义。方法将96例疑似VAP患儿根据是否确诊为VAP分为A组(n=70,确诊为VAP)和B组(n=26,未发生VAP)。将A组患儿根据用药依据分为对照组和研究组,每组35例。对照组根据医师经验选择抗生素治疗,研究组根据PCT水平变化变换抗生素治疗。比较A组和B组患儿WBC、PCT及CRP水平。比较研究组与对照组治疗过程中PCT水平变化、治疗及预后情况。结果A组机械通气48 h后PCT水平显著高于机械通气前和B组(P<0.05)。治疗第4、7、10天,研究组与对照组PCT水平均较治疗第1天显著降低,且研究组低于对照组(P<0.05)。研究组与对照组住院时间、治疗有效率及死亡率无显著差异(P>0.05)。研究组抗生素使用时间短于对照组,抗生素费用低于对照组(P<0.05)。结论PCT在VAP患儿中呈高表达,临床上根据PCT水平来选择抗生素治疗对缩短抗生素应用时间、节约医疗成本具有积极意义。

Objective To investigate the expression and clinical significance of procalcitonin(PCT)in neonatal ventilator associated pneumonia(VAP).Methods Ninety-six children with suspected VAP were divided into group A(n=70,diagnosed as VAP)and group B(n=26,no VAP)according to whether the children were diagnosed as VAP.The children in the group A were divided into control group and study group according to the medication basis,with 35 cases in each group.The control group was treated with antibiotics according to the experience of doctors,and the study group was treated with antibiotics according to the changes of PCT level.The WBC,PCT and CRP levels were compared between the group A and group B.The changes of PCT level during the treatment,treatment and prognosis of the study group and the control group were compared.Results The PCT level in the group A after 48 h mechanical ventilation was significantly higher than that before mechanical ventilation and in the group B(P<0.05).On the 4th,7th and 10th day of treatment,PCT levels in the study group and the control group were significantly lower than those on the 1 st day of treatment,and the PCT levels in the study group were lower than those in the control group(P<0.05).There were no significant differences in hospital stay,effective rate of treatment and mortality between the study group and the control group(P>0.05).The time of using antibiotics in the study group was shorter than that in the control group,and the cost of antibiotics was lower than that of the control group(P<0.05).Conclusion PCT is highly expressed in VAP children.Choosing antibiotics according to PCT level has positive significance in shortening the time of using antibiotics and saving medical costs.