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目的:探讨新生儿脓毒血症患儿的血清降钙素原(PCT)的水平变化及对患儿预后的预测价值。方法:回顾性分析该院儿科2011年7月~2013年2月收治的68例脓毒血症新生儿的临床资料,根据NCIS分组法分为非危重组29例,危重组22例,极危重组17例。对3组患儿的降钙素原(PCT)等指标进行比较,同时根据PCT是否>14.86(ng/ml)进行分组比较两组患儿的预后差异。结果:3组间患儿入院时的PCT、C-反应蛋白(CRP)、急性生理期与慢性健康评分标准Ⅱ(APACHEⅡ)值差异均有统计学意义(P<0.05);极危重组患儿的PCT(19.89±2.28)ng/ml、CRP(95.67±15.77)mg/dl、APACHEII(19.97±3.89)分均显著高于非危重组和危重组患儿(P<0.05),危重组患儿的PCT、CRP、APACHEII值均显著的高于非危重组患儿(P<0.05)。PCT≤14.8 ng/ml组患儿30天内死亡4例(9.756%),PCT>14.8 ng/ml患儿30天死亡19例(70.370%),PCT>14.8 ng/ml组患儿的死亡率显著高于PCT≤14.8 ng/ml组患儿(χ2=26.722,P=0.000)。PCT>14.8 ng/ml组患儿的中位生存时间20天显著低于PCT≤14.8 ng/ml组患儿的28天且差异有统计学意义(log-rankχ2=26.818,P=0.000)。结论:随着脓毒症患儿的病情严重程度加重,患儿的PCT水平显著升高,同时PCT水平越高患儿的预后越差。
Objective: To investigate the changes of serum procalcitonin (PCT) levels in children with neonatal sepsis and its prognostic value. Methods: The clinical data of 68 neonates with sepsis admitted to our hospital from July 2011 to February 2013 were retrospectively analyzed. According to NCIS classification, 29 cases were non-critically ill and 22 cases were critically ill Group of 17 cases. The procalcitonin (PCT) and other indexes in three groups were compared, and the differences of prognosis between the two groups were compared according to whether PCT was> 14.86 (ng / ml). Results: There were significant differences in PCT, C-reactive protein (CRP), acute physiology and chronic health score Ⅱ (APACHEⅡ) between the three groups at hospital admission (P <0.05) (19.89 ± 2.28) ng / ml, CRP (95.67 ± 15.77) mg / dl and APACHEII (19.97 ± 3.89) were significantly higher in non-critically ill and critically ill children (P <0.05) The PCT, CRP and APACHEII values were significantly higher in non-critically ill children (P <0.05). In the group of PCT≤14.8 ng / ml, 4 cases (9.756%) died within 30 days, 19 cases (70.370%) died within 30 days after treatment with PCT> 14.8 ng / ml, and those with PCT> 14.8 ng / ml Higher than PCT≤14.8 ng / ml group (χ2 = 26.722, P = 0.000). The median survival time of patients with PCT> 14.8 ng / ml was significantly lower than that of patients with PCT ≤ 14.8 ng / ml for 20 days (P <0.05). The difference was statistically significant (log-rankχ2 = 26.818, P = 0.000). CONCLUSIONS: With the aggravation of the severity of sepsis in children, PCT levels are significantly elevated in children, and the worse the prognosis of children with higher PCT levels.