不同类别细菌感染患儿血清降钙素原水平变化

Significance of serum procalcitonin levels in patients with different bacterial infections

摘要:

目的了解不同类别细菌感染患儿血清降钙素原（PCT）水平的变化，探讨血清PCT区分革兰阳性(G＋)菌和革兰阴性(G－) 菌感染的价值。方法以重症监护室收治的266例全身重症细菌感染患儿为研究对象，根据细菌培养结果分为G＋菌组和G－菌组,分别检测2组患儿血清PCT、C反应蛋白（CRP）水平和白细胞（WBC）计数、中性粒细胞百分比(Neu%)，并对2组资料进行统计分析。结果全身重症细菌感染患儿血清PCT水平明显升高，以PCT≥2.0 ng/mL为阳性，G－菌组阳性率（92.36%）显著高于G＋菌组（76.23%）(χ2=13.45,P＜0.001)；当PCT≥10.0 ng/mL时,G－菌感染可能性更大。而常规感染指标CRP、WBC计数及Neu%，G＋菌组阳性率与G－菌组差异无统计学意义(均P＞0.05)。结论血清PCT水平作为区分G＋菌和G－菌感染指标有一定价值，能为重症感染患儿早期使用相应抗菌药物治疗提供参考依据。

Abstract:

ObjectiveTo investigate the changes in serum procalcitonin (PCT) levels in patients with different bacterial infections and to evaluate the significance of PCT levels for differentiating grampositive and gramnegative bacterial infection. MethodsTwo hundren and sixtysix intensive care unit（ICU）patients infected with severe bacterial infections were divided into 2 groups (grampositive bacteria group and gramnegative bacteria group) according to the bacterial culture results, and serum PCT, Creaction protein(CRP), white blood cell(WBC) and neutrophil ratio（Neu%） were detected, and data of two groups were analysed statiscally. ResultsSerum levels of PCT in patients with severe bacterial infection significantly rose. When defined by the value of PCT ≥2 ng/mL as positive, the positive rate of PCT in gramnegative bacteria group (92.36%) was significantly higher than that of grampositive bacteria group (76.23%)(χ2=13.45, P<0.001); When the value of PCT ≥10 ng/mL, the possibility of gramnegative bacterial infection was great. The routine infection markers, including CRP,WBC and Neu% , were not significantly different between grampositive bacteria group and gramnegative bacteria group( both P＞0.05）. ConclusionPCT levels can be used as indicator for differentiating grampositive and gramnegative bacterial infection, and may provide valuable information for sensitive antimicrobial selection.