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目的研究血清降钙素原(PCT)及超敏C反应蛋白(hs-CRP)对不同感染状态下的儿童含量及抗生素治疗的应用价值。方法选择我院收治的感染患儿274例作为研究对象,根据患儿感染严重状态分为76例重症细菌感染组,73例局部细菌感染组,其余125例非细菌感染患儿作为对照组。对全部患儿进行血常规、PCT和hs-CRP的检测,同时根据病情、PCT水平等对重症细菌感染患儿制定不同的抗生素治疗方案。观察比较各组PCT、hs-CRP的变化及治疗效果。结果重症细菌感染组PCT高于局部细菌感染组,而局部细菌感染组PCT高于对照组,差异均有明显统计学意义(均P<0.01);局部细菌感染组hs-CRP高于对照组(P<0.01),而重症细菌感染组与局部细菌感染组比较无统计学差异(P>0.05)。149例细菌感染患儿PCT的阳性率85.9%明显高于hs-CRP的阳性率38.9%,差异有统计学意义(P<0.01)。重症细菌感染患儿治疗后PCT和hs-CRP水平均较治疗前明显下降(均P<0.01)。重症细菌感染治疗的PCT指导组患儿的住院时间及住院费用均明显少于非PCT指导组,差异均有统计学意义(均P<0.01)。结论与hsCRP相比,PCT可作为细菌感染的早期诊断及感染严重程度判断的重要可靠指标,同时PCT的动态监测可为评估抗生素疗效及合理优化重症细菌感染患儿的治疗方案,提供有价值的指导。
Objective To investigate the value of serum procalcitonin (PCT) and hs-CRP in children with different infection status and antibiotic therapy. Methods Totally 274 children with infectious diseases admitted to our hospital were selected as research objects. According to their severe infection status, they were divided into 76 cases of severe bacterial infection group, 73 cases of local bacterial infection group and 125 cases of non-bacterial infection as control group. All children with blood tests, PCT and hs-CRP testing, according to the disease, PCT levels of children with severe bacterial infection to develop different antibiotic treatment programs. The changes of PCT and hs-CRP in each group were observed and compared. Results The PCT of severe bacterial infection group was higher than that of local bacterial infection group, while PCT of local bacterial infection group was higher than that of control group (all P <0.01). The hs-CRP of local bacterial infection group was higher than that of control group P <0.01), while there was no significant difference between severe bacterial infection group and local bacterial infection group (P> 0.05). The positive rate of PCT in children with bacterial infection was 85.9%, which was significantly higher than that of hs-CRP (38.9%), the difference was statistically significant (P <0.01). The levels of PCT and hs-CRP in children with severe bacterial infection were significantly lower than those before treatment (all P <0.01). The hospitalization and hospitalization costs of PCT guidance group were significantly less than those of non-PCT guidance group (all P <0.01). Conclusions Compared with hsCRP, PCT can be used as an important reliable indicator for the early diagnosis of bacterial infection and judgment of the severity of infection. At the same time, the dynamic monitoring of PCT can provide valuable and valuable information for evaluating the curative effect of antibiotics and optimizing the treatment of severe bacterial infections in children guide.