降钙素原对指导小儿系统性炎症反应综合征抗菌药物治疗的临床观察

目的：探讨检测血浆降钙素原（PCT）对系统性炎症反应综合征（SIRS）患儿进行抗菌药物治疗的临床效果及其意义。方法选择2012年4月至2014年3月广州医科大学附属深圳市宝安区沙井人民医院收治的100例 SIRS患儿为研究对象。入院时对其进行血浆 PCT检测后，将其按照入院顺序单、双号随机纳入PCT指导治疗组（n=50）与常规治疗组（n=50）。对两组患儿均予以积极对症、支持治疗。对常规治疗组按照《抗菌药物临床应用指导原则》制定抗菌药物治疗方案，对 PCT指导治疗组依照血浆 PCT值动态监测结果制定抗菌药物治疗方案。对两组 SIRS 患儿的住院费用及时间、抗菌药物使用时间及费用、抗菌药物使用率及其临床疗效、并发症发生率及患儿死亡率进行相关统计学分析（本研究遵循的程序符合广东医科大学附属深圳市宝安区沙井人民医院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象监护人的知情同意，并与其签署临床研究知情同意书）。两组患儿年龄、性别等一般资料比较，差异均无统计学意义（P＞0.05）。结果 PCT指导治疗组的住院费用、抗菌药物使用时间及费用、抗菌药物使用率、临床有效率等各项指标均显著优于常规治疗组，且差异有统计学意义（P＜0.05）。两组住院时间、治疗后感染性休克或多器官功能障碍综合征（MODS）发生率等比较，差异均无统计学意义（P＞0.05）。结论血浆PCT值作为炎症反应的敏感检测指标，可用于指导临床对 SIRS患儿抗菌药物的治疗。

Clinical Observation of Plasma Procalcitonin in Guiding Pediatric Systemic Inflammatory Response Syndrome

Objective To study the clinical effects and significance of plasma procalcitonin （PCT）in guiding pediatric systemic inflammatory response syndrome （SIRS ） antibacterial drug therapy. Methods From April 2012 to March 2014,a total of 100 children with SIRS who hospitalized in Baoan District of Shenzhen Shajing People′s Hospital Affiliated to Guangzhou Medical College were studied.After admission and detection of plasma PCT,they were randomly divided into PCT treatment group （n=50）and conventional treatment group （n=50）by admission odd and even numbers.They all were given positive symptomatic and supportive treatment.Conventional treatment group developed antibacterial drug therapy program in accordance with the＆quot;Guidelines for Clinical Use of Antibacterial Drugs＆quot;,PCT treatment group developed antibacterial drug therapy program in accordance with the values of plasma PCT dynamic monitoring results.Expenses and duration of hospitalization,expenses and duration of taking antibacterial drugs and its clinical curative effects,the incidence of complications and mortality were statistically analyzed between two groups.The study protocol was approved by the Ethical Review Board of Investigation in Baoan District of Shenzhen Shajing People′s Hospital Affiliated to Guangzhou Medical College.Informed consent was obtained from the guardians of each participate.There had no significant differences of age and gender between two groups （P＆gt;0.05）.Results The hospitalization expenses,duration and expenses of antibacterial drugs,rates of antibacterial drug usage and clinical efficiency indicators in PCT treatment group＆amp;nbsp;were significantly better than those in conventional treatment group,with significant difference （P＆lt;0.05）. There had no significant differences between two groups among duration of hospitalization,incidence of septic shock,rates of multiple organ dysfunction syndrome （MODS）（P＆gt;0.05 ）.Conclusion As a sensitive detection index of inflammatory react