血清降钙素原联合病原学检测在学龄前儿童下呼吸道感染中的临床作用

Clinical Effect of Serum Procalcitonin Combined with Pathogen Detection on Lower Respiratory Tract Infection in Preschool Children

目的:探讨血清降钙素原(PCT)联合病原学检测在学龄前儿童下呼吸道感染中的临床意义。方法:选择2018年7月-2019年11月笔者所在医院儿科收治的下呼吸道感染的学龄前儿童97例设为观察组,同时选取同期健康体检的学龄前儿童60例设为对照组。观察组患儿均进行病原学检测及血清PCT检测,对照组进行血清PCT检测。观察组以PCT及病原学检测结果为依据,给予患儿对应抗生素药物治疗。监测观察组病原学种类,比较两组PCT水平,以及观察组治疗前后PCT水平变化情况。比较PCT检测、病原学检测及联合检测的诊断阳性率。结果:97例下呼吸道感染患儿中,经病原菌检测确定为阳性49例,检测阳性率为50.52%,阴性48例,占49.48%,阳性中以细菌感染为主,分离出49株细菌,其中革兰阴性菌29株(59.18%),革兰阳性菌20株(40.82%)。观察组治疗前血清PCT水平明显高于对照组,差异有统计学意义(P<0.01);观察组治疗后PCT水平较治疗前明显降低,差异有统计学意义(P<0.01)。血清PCT联合病原学检测的诊断阳性率(91.75%)明显高于PCT检测(81.44%)及病原学检测(50.52%),差异有统计学意义(P<0.01)。结论:采用病原学检测联合PCT检测有助于学龄前儿童下呼吸道感染的早期诊断及精准治疗。

Objective:To explore the clinical significance of serum procalcitonin(PCT)combined with pathogen detection on lower respiratory tract infection in preschool children.Method:A total of 97 preschool children with lower respiratory tract infection admitted in the pediatrics department of our hospital from July 2018 to November 2019 were selected as the observation group.At the same time,60 preschool children who underwent physical examination during the same period were selected as the control group.All the children in the observation group were detected for pathogen and serum PCT,and the control group was detected for serum PCT.The observation group was treated with corresponding antibiotics based on the results of PCT and pathogen detection.The pathogen types of the observation group were monitored,and the PCT levels of the two groups were compared,as well as the changes of PCT levels of the observation group before and after treatment.The diagnostic positive rates of PCT,pathogen and combined detection were compared.Result:Among the 97 cases of children with lower respiratory tract infection,49 cases were confirmed as positive by pathogen detection,the positive rate was 50.52%,and 48 cases were negative,accounting for 49.48%.The positive cases were mainly bacterial infection,and 49 strains of bacteria were isolated,among which 29 strains(59.18%)were gram-negative and 20 strains(40.82%)were gram-positive.Before treatment,the serum PCT level of the observation group was significantly higher than that of the control group,the difference was statistically significant(P<0.01).After treatment,the PCT level in the observation group was significantly decreased compared with that before treatment,and the difference was statistically significant(P<0.01).The diagnostic positive rate of serum PCT combined with pathogen detection(91.75%)was significantly higher than that of PCT detection(81.44%)and pathogen detection(50.52%),the differences were statistically significant(P<0.01).Conclusion:The combination of pathogen detection and PCT detection is helpful for the early diagnosis and accurate treatment of lower respiratory tract infection in preschool children.