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目的讨论全身炎症反应综合征(SIRS)患儿治疗中血清降钙素原(PCT)的变化及实用价值研究。方法选择2010年1月-2013年1月河南省南阳市第一人民医院儿科收治的符合SIRS诊断标准的危重患儿60例及健康对照组60例,其中SIRS患儿根据是否合并多器官功能障碍(MODS)分为MODS组(10例)和非MODS组(50例);依据血培养结果分为细菌感染组(40例)和非细菌感染组(20例);根据预后分为未痊愈组11例(包括转上级医院及死亡病例)和治愈组49例。入院后24 h内测试PCT和C反应蛋白(CRP)水平,并做统计学分析。结果健康对照组患儿PCT、CRP水平明显低于观察组;非细菌感染组血清PCT水平明显低于细菌感染组(P<0.05),2组CRP水平比较差异无统计学意义(P>0.05);MODS组血清PCT明显高于非MODS组(P<0.01),2组间血清CRP水平比较差异无统计学意义(P>0.05);痊愈组患儿PCT及CRP值明显低于未痊愈组患儿PCT浓度(P<0.05)。结论 PCT检测是诊断儿童细菌感染性疾病的可靠实验室指标,对SIRS患儿的治疗及预后具有非常重要的价值。
Objective To investigate the changes and clinical value of serum procalcitonin (PCT) in the treatment of children with systemic inflammatory response syndrome (SIRS). Methods Sixty critically ill children with SIRS criteria and 60 healthy controls were enrolled in the First People’s Hospital of Nanyang City, Henan Province from January 2010 to January 2013. SIRS children were divided according to whether they had multiple organ dysfunction (MODS) were divided into MODS group (n = 10) and non-MODS group (n = 50). According to the result of blood culture, the patients were divided into bacterial infection group (n = 40) and non-bacterial infection group 11 cases (including transfer to superior hospitals and deaths) and cured group of 49 cases. The levels of PCT and C-reactive protein (CRP) were tested within 24 h after admission and were analyzed statistically. Results The levels of PCT and CRP in children in the control group were significantly lower than those in the observation group. The levels of PCT in the non-bacterial group were significantly lower than those in the bacterial group (P <0.05). There was no significant difference in CRP levels between the two groups (P> 0.05) ; The serum PCT in MODS group was significantly higher than that in non-MODS group (P <0.01), there was no significant difference in serum CRP level between the two groups (P> 0.05); PCT and CRP in recovery group were significantly lower than those in non-cured group PCT concentration (P <0.05). Conclusion PCT test is a reliable laboratory index for the diagnosis of bacterial infectious diseases in children and is of great value to the treatment and prognosis of children with SIRS.