细菌感染重症肺炎患儿血清前白蛋白与降钙素原比值和病情转归的关系探讨

Study on the Relationship between the Ratio of Serum Prealbumin to Procalcitonin and the Outcome of Bacterial Infection in Children with Severe Pneumonia

目的比较并筛选机体营养状态和炎症状态指标,作为细菌感染重症肺炎患儿预后的短期预测指标。方法选择2017年1月—2019年12月沈阳市儿童医院收治的重症细菌感染肺炎患儿127例,依据病情分为危重组85例和极危重组42例,比较两组患儿前白蛋白(PA)、白蛋白(ALB)和降钙素原(PCT)、急性期蛋白(CRP)及其之间比值差异。然后根据治疗结局将患儿分为非死亡组104例和死亡组23例,进一步探讨上述指标组间差异。结果危重组PA、PA/PCT和ALB/PCT水平均高于极危重组,而PCT低于极危重组,差异均有统计学意义(P<0.05)。非死亡组PA、PA/PCT和ALB/PCT水平均高于死亡组,而PCT低于死亡组,差异均有统计学意义(P<0.05)。结论PA、PCT、ALB及其比值作为重症肺炎患儿短期病情严重程度与预后评估的指标具有一定的临床应用价值。

Objective To compare and screen the indexes of nutritional status and inflammatory status of the body as the short-term predictors of the prognosis in children with severe pneumonia caused by bacterial infection.Methods A total of 127 children admitted to Shenyang Children’s Hospital with severe bacterial infection pneumonia from January 2017 to December 2019 were selected.According to their condition,they were divided into 85 cases of critical group and 42 cases of severe critical group.The differences of prealbumin(PA),albumin(ALB),procalcitonin(PCT),acute phase protein(CRP)and their ratio between the two groups were compared.Then according to the outcome of treatment,the children were divided into non death group(104 cases)and death group(23 cases),and the differences of above indexes were compared between two groups.Results The levels of PA,PA/PCT and ALB/PCT were significantly higher than those of severe critical group,while PCT was significantly lower than that of severe critical group(P<0.05).The levels of PA,PA/PCT and ALB/PCT in non death group were significantly higher than those in death group,while PCT was significantly lower than that in death group(P<0.05).Conclusion PA,PCT,ALB and their ratio have a certain clinical application value as indicators of short-term severity and prognosis of severe pneumonia.