检测降钙素原在儿童呼吸机相关性肺炎中的临床应用

目的探讨降钙素原在儿童呼吸机相关性肺炎中检测的临床应用。方法研究对象为2013年1~11月我院PICU中非感染情况上呼吸机并且上机前血清PCT正常的患儿30例,按照患儿在≤7 d的机械通气时间内是否有VAP发生分为两组,观察组15例为上机后患有VAP的患儿;对照组15例为上机后未出现VAP的患儿。检测并比较机械通气前后的血清PCT水平。结果观察组的PCT水平在机械通气前与对照组比较差异无统计学意义(P>0.05),机械通气后观察组的阳性率明显高于对照组(P<0.05)。观察组患者上机后2 d、上机后4 d及上机后7 d的PCT水平均高于对照组,差异有统计学意义(P<0.05),上机前及治愈后PCT水平两组间差异无统计学意义(P>0.05)。观察组患者随着病情的改善,PCT值逐渐降低,上机前、上机后2 d、上机后4 d、上机后7 d及治愈后的PCT水平差异有统计学意义(P<0.05)。结论小儿呼吸机相关性肺炎中血清PCT的敏感性较高,对血清PCT水平进行及时的检测有利于小儿VAP疾病的诊断。

Clinical value of procalcitonin testing in children ventilator associated pneumonia

Objective To investigate clinical value of procaleitonin in children ventilator-associated pneumonia. Methods All 30 subjects were selected from January to November 2013 in our hospital PICU no-infection status and on the machine before the ventilator normal serum PCT patients, according to duration of mechanical ventilation if there were VAP ≤7 d, the children were divided into two groups, the observation group （n=15）, all of them were with VAP on the plane after suffering children; control group （n=15）, all of them were without VAP on the machine after the children. Serum PCT levels before and after mechanical ventilation were measured and compared. Results PCT levels in the observation group before mechanical ventilation compared with the control group showed no significant difference （P〉0.05）, mechanical ventilation of the observation group were significantly higher （P〈0.05）. After the observation group were on the plane 2 d, 4 d and the machine after the machine after 7 d of PCT levels were higher, the difference was signifieant（P 〈0.05）, the machine PCT levels before and after the cure was no significant difference between two groups （P〉 0.05）. The patients with the condition improved, PCT values decreased, on the front, on the plane after the 2 d, the machine after 4 d, 7 d and heal after the machine after PCT levels were significantly （P〈0.05）. Conclusion Serum PCT sensitivity of ventilator associated pneumonia in pediatric is higher, and detecting the serum PCT levels timely is beneficial to diagnosis of pediatric VAP.