PCT联合心脏相关标志物对脓毒症患儿病情的预测价值

目的 探讨降钙素原(PCT)联合心脏相关标志物检测在脓毒症患儿病情预测中的价值.方法 选取脓毒症患儿132例,其中早期脓毒症患儿87例(早期脓毒症组),严重脓毒症患儿45例(严重脓毒症组),检测患儿PCT、肌酸激酶同工酶(CK-MB)、超敏肌钙蛋白T(cTnT-hs)和氨基末端脑钠肽前体(NT-proBNP)水平.结果 早期脓毒症组和严重脓毒症组患儿性别、年龄以及感染部位分布比较,差异无统计学意义(P>0櫃.05);严重脓毒症组PCT、CK-MB、cTnT-hs和NT-proBNP明显高于早期脓毒症组(P<0.05);PCT、CK-MB、cTnT-hs、NT-proBNP预测严重脓毒症的ROC曲线下面积分别为0.982、0.880、0.730和0.947,灵敏度分别为90.03%、68.90%、46.70%和84.63%.将PCT与CK-MB、cTnT-hs和NT-proBNP联合诊断严重脓毒症,其诊断灵敏度为97.80%,高于各指标单独使用时.结论 PCT联合心脏相关标志物检测在脓毒症患儿病情预测中有较高的应用价值,值得进一步研究.

Clinical value of PCT combined with cardiac related parameters in predicting the pathogenetic condition of children with sepsis

Objective To investigate the value of procalcitonin ( PCT) combined with cardiac related parameters in predicting the pathogenetic condition of children with sepsis .Methods One hundred and thirty -two children patients with sepsis who were treated in our hospital from March 2014 to May 2016 were divided into early sepsis group ( n =87 ) and severe sepsis group ( n =45).The serum levels of PCT,creatine kinase isoenzyme (CK-MB),high sensitive cardiac troponin T (cTnT-hs) and N-terminal pro brain natriuretic peptide (NT-proBNP) were detected and compared between two groups . Results There were no significant differences in the sex ,age and distribution of infection position between two groups ( P >0.05).The serum levels of PCT,CK-MB,cTnT-hs and NT proBNP in severe sepsis group were significantly higher than those in early sepsis group ( P <0.05).The area under ROC curve of PCT ,CK-MB,cTnT-hs,NT-proBNP and ROC in predicting severe sepsis was 0.982,0.880,0.730,0.947,respectively, and the diagnostic sensitivity was 90.03%,68.90%,46.70%, 84.63%,respectively.However the diagnostic sensitivity of PCT combined with CK-MB,cTnT-hs and NT-proBNP in diagnosis of severe sepsis was 97 .80%, which was higher than that by single index detection .Conclusion The detection of PCT combined with cardiac related parameters has higher application value ,thus, which is worth researching further .