脓毒症、严重脓毒症危重患儿血清降钙素原水平变化及临床意义

目的：探讨血清降钙素原（PCT）对脓毒症、脓毒性休克患儿的诊断价值及临床意义。方法近期收治的脓毒症、严重脓毒症患儿及正常对照组（非脓毒血症组）各30例，入院第1、3、7天抽取外周血检测肝肾功能、心肌酶、WBC 计数、PCT 及 CRP 值。结果严重脓毒症组 PCT 高于脓毒症组（P ＜0．05），严重脓毒症及脓毒症组PCT 均高于正常对照组（P ＜0．05），经积极抗感染治疗1周左右，脓毒症组及严重脓毒症组两组患儿临床症状好转，体温正常，血清 PCT 水平逐步下降，血 CRP 有慢于 PCT 趋势。CRP 和 PCT 的灵敏度一样，为70％；PCT 的特异度为76．7％，高于 CRP 的63．3％。结论降钙素原水平在脓毒症及严重脓毒症时明显增高，可作为早期诊断指标。PCT 的特异度高于 CRP。

Clinical significance and changes of the serum procalcitonin in children with sepsis and septic shock

Objective To investigate the serum procalcitonin (PCT)in children with sepsis and septic shock in the diagnostic value and clinical significance.Methods The prospective research,clinical observation,the object of study for January 2013 to Sep 2015 in our hospital intensive care division (PICU)of sepsis patients treated 30 cases, 30 cases of children with severe sepsis in normal control group.Peripheral blood test liver function,renal function, myocardial enzyme,the WBC count,PCT and CRP were detected in dynamic detection after hospitalized 1,3,7 days .Results Children with severe sepsis PCT were higher than that of sepsis group (P <0.05),severe sepsis and PCT sepsis group were higher than in normal control group (P <0.05).the positive anti-infection treatment 7 days a-round 1 week,sepsis and severe sepsis group two groups of children with clinical symptoms were improved,temper-ature was normal,serum PCT level gradually declined,blood CRP was slower than the PCT trend.The sensitivity Sepsis with CRP and PCT that was 70%,but specificity of PCT was 76.7% and was higher than the 63.3% of CRP.Conclusion Calcitonin original during sepsis and severe sepsis obviously increased can be used as early diagnos-tic indicators.The study confirmed the specific degree of PCT higher than CRP.