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目的对于儿童感染性疾病,应用小儿危重病例评分,检测血清D-二聚体(D-D)及降钙素原(PCT)对患儿病情进行早期评估,为临床诊断及治疗提供依据。方法选择湖州市第一人民医院2014年1月-2015年12月感染性疾病患儿368例,其中细菌性感染187例(细菌组),非细菌性感染181例(病毒组),按照小儿危重病例评分法(PCIS)进行评分,危重程度≤70分为极危重(46例),70~80分为危重(87例),>80分为非危重(235例),检测各组血清PCT、D-D浓度,计算阳性率,并记录PCIS评分。结果细菌组患儿血清PCT阳性率为70.59%,D-D浓度为(16.51±0.93)mg/L,非细菌组为29.83%和(3.86±0.81)mg/L,两组比较,差异具有统计学意义(P<0.05)。两组患儿血清D-D和PCIS结果比较,差异无统计学意义(P>0.05)。非危重患儿血清PCT、D-D阳性率和浓度分别为42.13%、(13.68±0.81)μg/L和34.89%、(2.45±0.72)mg/L,均低于危重和极危重患儿,并且危重低于极危重患儿,差异具有统计学意义(P<0.05)。结论细菌性感染患儿血清PCT水平显著升高,随着疾病严重程度,患儿血清PCT和D-D阳性率和浓度呈递增趋势,PCIS联合血清D-D及PCT对儿童感染病情的早期诊断、病情程度评估具有重要的临床意义。
Objective To evaluate the pediatric infectious diseases, evaluate the severity of pediatric cases, detect the serum D-dimer (D-D) and procalcitonin (PCT), and provide the basis for clinical diagnosis and treatment. Methods The First People’s Hospital of Huzhou from January 2014 to December 2015 368 cases of infectious diseases in children, including bacterial infection in 187 cases (bacterial group), non-bacterial infection in 181 cases (virus group), according to the critical risk of children (PCIS) were scored. The patients were classified as critically ill (≤ 46), critically ill ≤ 70 as critically ill (n = 87) and> 80 as non-critically ill (n = 235) DD concentration, calculate the positive rate, and record the PCIS score. Results The serum PCT positive rate was 70.59%, the DD concentration was (16.51 ± 0.93) mg / L in the bacterial group, and 29.83% and (3.86 ± 0.81) mg / L in the non-bacterial group, the difference was statistically significant (P <0.05). Two groups of children with serum D-D and PCIS results, the difference was not statistically significant (P> 0.05). The positive rates of PCT and DD in the non-critically ill children were 42.13% (13.68 ± 0.81) μg / L and 34.89% (2.45 ± 0.72) mg / L, respectively, which were lower than those in critically ill and critically ill children, The difference was statistically significant (P <0.05). Conclusions Serum PCT levels in children with bacterial infections were significantly increased. With the severity of the disease, the positive rate and concentration of serum PCT and DD in children showed an increasing trend. PCIS combined with serum DD and PCT in early diagnosis of children’s infection and evaluation of their severity Has important clinical significance.