危重症患儿感染时血清降钙素原和D-二聚体水平研究

目的探讨血清降钙素原（PCT）和D-二聚体（D-D）检测在诊断小儿危重症感染中的作用。方法采用固相免疫色谱法和免疫比浊法分别测定危重患儿的血清PCT和D—D水平，并与C反应蛋白（CRP）和WBC计数作比较。结果与无临床感染指征组相比，有临床感染指征组患儿中PCT阳性率和D—D水平明显升高（P〈0．01），而CRP和WBC计数在二组中差异无显著性（P〉0．05）；PCT和D—D水平与患儿病情的严重程度呈正棚关。结论PCT与DD均可作为早期识别危重症患儿感染性疾病及其严重性的重要指标；DD水平检测对早期诊断危重患儿感染时凝血功能异常的程度与广度具有重要意义，同时为临床早期应用抗凝药物治疗小儿危重症感染性疾病提供了理论依据。

Study on Levels of Serum Procalcitonin and D-Dimer in Critically-illed Paediatric Patients with Infection

Objective To evaluate the clinical significance of the detection of serum procalcitonin（PCT） and O - Oimer （D- D） in the diagnosis of infection in critically - illed paediatric patients. Methods Solid - phase immune chromatography and immune nephelometry were used to determine the levels of serum POT and D- D in 305 critically- illed children, and the testing data were compared with the levels of C- reactive protein （CRP） and white blood cell count. Results The positive rate of POT and the level of D - D in the infected group were significantly higher than those in the non- infected group （P〈 0.01 ）. However, the differences of CRP level and white blood cell count between them were not significant （P 〉0.05）. The levels of POT and D D were positively correlated to the severity of the illness. Conclusions POT and D - D are both important markers for early recognizing of the infectious diseases and the severity of the illness in the critically- filed paediat- ric patients. The detection of D - D plays an important role in early diagnosis of the degree and the width of coagulation disorder, and also provides the theoretic basis for paediatrists to use anticoagulation drugs for treating the critically- illed paediatric patients with infection.