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目的研究多重PCR检测在严重脓毒症感染患儿中的应用及临床意义,为指导临床治疗提供依据。方法选取2014年10月-2015年10月医院诊治192例严重脓毒症并发感染患儿资料进行分析,患儿入院后进行常规方法检测,利用多重PCR技术定量检测患儿脑脊液EB病毒(EBV)、单纯疱疹病毒(HSV)、巨细胞病毒(CMV)以及肺炎支原体(MP)的核酸含量,并与脑脊液中特异性抗体结果进行比较,分析多重PCR在严重脓毒症并发感染患儿中的应用效果。结果入选192例患儿,84例阳性,阳性率为43.8%,且患儿主要集中在(3~6)岁年龄段;84例患儿脑脊液DNA阳性主要分布在EBV,占46.4%,其次分布HSV,占28.6%;84例患儿中,22例重型,62例轻型,重型患儿EBV-IgM、HSV-IgM、CMV-IgM以及MP-IgM水平,显著高于轻型患儿(P<0.05);192例患儿中,45例IgM阳性,145例IgM阴性;患儿中多重PCR检测184例阴性,84例阳性。结论严重脓毒症并发感染患儿采用多重PCR技术临床诊断效果理想,能成为脓毒症患儿常规检测手段,为提高临床诊断效果具有重要意义。
Objective To study the application and clinical significance of multiplex PCR in children with severe sepsis infection and provide the basis for clinical treatment. Methods The data of 192 children with severe sepsis complicated with infection from October 2014 to October 2015 in our hospital were analyzed. The children were admitted to the hospital for routine testing and the quantitative PCR was used to detect Epstein-Barr virus (EBV) , Herpes simplex virus (HSV), cytomegalovirus (CMV) and Mycoplasma pneumoniae (MP), and compared with results of specific antibodies in cerebrospinal fluid (CSF) to analyze the application of multiplex PCR in children with severe sepsis complicated with infection effect. Results A total of 192 children were enrolled, of which 84 were positive, with a positive rate of 43.8%. The majority of children were in the age range of (3-6) years. The positive rate of cerebrospinal fluid DNA in 84 children was mainly EBV (46.4%), followed by HSV accounted for 28.6%. Among the 84 cases, the levels of EBV-IgM, HSV-IgM, CMV-IgM and MP-IgM were significantly higher in 22 cases of severe and 62 cases of mild and severe ). Of the 192 children, 45 were IgM positive and 145 were IgM negative; 184 were negative in multiplex PCR and 84 were positive in children. Conclusion The clinical diagnosis results of multiple PCR in children with severe sepsis complicated with infection are satisfactory and can be used as a routine test in children with sepsis, which is of great significance for improving clinical diagnosis.