论文部分内容阅读
目的 探讨严重感染患儿血浆前降钙素 (PCT)的特点 ,确定导致PCT增高的相关因素 ,评价其预测价值 ,并与C反应蛋白 (CRP)和嗜中性粒细胞计数作比较。设计前瞻性观察研究 ,4 8h病例追踪研究。地点 一所大学儿童医院的儿童重症监护病房 ,该病房与一儿童临床免疫实验室合作。患儿 18例怀疑败血症收入PICU的儿童 (平均年龄3 1岁 ,范围 1个月～ 16岁 )。治疗 所有患儿均按常规给予抗生素治疗 ,并根据患儿是否出现休克或呼吸衰竭给予相应的液体复苏 ,血管活性药物和机械通气治疗。测量和主要结果 对所有患儿在入院时测定血浆PCT和CRP ,如可能在随后的 6、12、2 4、4 8h分别测定。在大多数病例 ,PCT在入院时已很高 (范围 1 0～ 72 2ng/ml) ,之后增高并不明显。与C反应蛋白相反 ,血浆PCT不随患儿的年龄变化而变化。在休克或多器官功能障碍、严重程度评分高 (儿童病死率危险度 )或后来死亡的患儿PCT明显增高。结论 患败血症儿童的血浆PCT水平很快增高 ,即使在小于 12个月的婴儿也是如此。与CRP和嗜中性粒细胞计数相比 ,PCT对判断预后具有更大的价值
Objective To investigate the characteristics of pre-procalcitonin (PCT) in children with severe infection and to determine the relevant factors that lead to the increase of PCT. The predictive value of PCT was evaluated and compared with C-reactive protein (CRP) and neutrophil count. Design prospective observational studies, 48h case follow-up studies. Location Children’s intensive care unit at a University Children’s Hospital, which works with a clinical immunization laboratory for children. 18 children with PICU who were suspected of having septicemia (mean age, 31 years, range, 1 month to 16 years). All children treated according to routine antibiotics, and according to whether the child was shock or respiratory failure to give the appropriate liquid resuscitation, vasoactive drugs and mechanical ventilation treatment. MEASUREMENTS AND MAIN RESULTS All plasma PCT and CRP were measured on admission to hospital, as may be measured at subsequent 6,12,2,4,48 h. In most cases, the PCT was already high at admission (range 10-72 2 ng / ml), with no apparent increase thereafter. In contrast to C-reactive protein, plasma PCT does not change with age in children. PCT was significantly higher in children with shock or multiple organ dysfunction, a higher severity score (risk of child mortality, or later death). Conclusions Plasma PCT levels in children with sepsis are rapidly increasing, even in infants younger than 12 months. Compared with CRP and neutrophil counts, PCT is of greater value in judging prognosis