血清降钙素原在儿科脓毒性休克中的鉴别诊断和监测作用

目的探讨血清降钙素原（PCT）在儿科脓毒性休克中的鉴别诊断和监测作用。方法将我院收治的脓毒性休克患儿68例作为研究对象，检测患儿白细胞计数（WBC）、C反应蛋白（CRP）和PCT水平，分析脓毒性休克早期和失代偿期上述指标变化。同时进行血细菌培养，比较不同病原体所致的脓毒性休克时WBC、CRP和PCT水平。结果①68例患儿中脓毒性休克早期39例，脓毒性休克失代偿期29例，两组患儿体温、CRP、WBC水平差异无统计学意义（P〉0．05）；脓毒性休克失代偿期患儿PCT水平明显高于脓毒性休克早期患儿（P〈0．01）。②68例患儿血培养结果显示。G＋感染27例，G-感染41例，G＋感染与G-感染患儿CRP、WBC水平差异无统计学意义（P〉0．05）；G-感染患儿PCT水平显著高于制惑染患儿，G＋感染患儿PCT在2．1～10．0¨g几者居多，占66．67％，G-惑染患儿PCT在〉10．0μg／L者居多，占73．17％。结论血清降钙素原对小儿脓毒性休克的鉴别诊断有一定意义，可以作为诊断小儿脓毒性休克的有效指标。

Role of serum procalcitonin in the differential diagnosis and monitoring of pediatric septic shock

Objective To investigate the role of serum procalcitonin(PCT) in monitoring and differential diagnosis of pediatric septic shock.Methods 68 cases of pediatric septic shock children treated in authors’ hospital were chosen as study subjects.Changes of white blood cell count(WBC),C-reactive protein(CRP) and serum PCT levels in early and decompensation stages of pediatric septic shock were detected.Hemoculture was also performed,WBC,CRP and serum PCT levels between different pathogens caused septic shocks were compared.Results ① Among 68 cases of septic shock children,39 cases were in early stage and 29 cases were in decompensation stage.The differences of body temperature,CRP and WBC levels of the two stages were not significant(P > 0.05);PCT level of the decompensation stage patients was significantly higher than that of the early stage patients(P < 0.01).②Hemoculture results showed that 27 cases had G+ infection and 41 cases had G-infection.CRP and WBC levels between the two groups were not significantly different(P > 0.05);PCT level of patients with G-infection was significantly higher than those of patients with G+ infected.PCT level of patients with G+ infected was mostly in the range of 2.1-10.0 μg/L,accounted for 66.67% of the total number,while PCT level of patients with G-infection was mostly higher than 10.0 μg/L,accounted for 73.17% of the total number.Conclusion Serum PCT is relevant in the differential diagnosis of septic shock,thus it can be used as an effective indicator for pediatric septic shock diagnosis.