摘要
目的了解不同类别细菌感染患儿血清降钙素原(PCT)水平的变化,探讨血清PCT区分革兰阳性(G)菌和革兰阴性(G^-)菌感染的价值。方法以重症监护室收治的266例全身重症细菌感染患儿为研究对象,根据细菌培养结果分为G菌组和G^-菌组,分别检测2组患儿血清PCT、C反应蛋白(CRP)水平和白细胞(WBC)计数、中性粒细胞百分比(Neu%),并对2组资料进行统计分析。结果全身重症细菌感染患儿血清PCT水平明显升高,以PCT≥2.0 ng/m1为阳性,G^-菌组阳性率(92.36%)显著高于G^+菌组(76.23%)(x^2=13.45,P<0.001);当PCT≥10.0 ng/m1时,G^-菌感染可能性更大。而常规感染指标CRP、WBC计数及Neu%,G^+菌组阳性率与G^-菌组差异无统计学意义(均P>0.05)。结论血清PCT水平作为区分G^+菌和G菌感染指标有一定价值,能为重症感染患儿早期使用相应抗菌药物治疗提供参考依据。
Objective To investigate the changes in serum procalcitonin （PCT） levels in patients with different bacterial infections and to evaluate the significance of PCT levels for differentiating gram-positive and gram-negative bacterial infection. Methods Two hundren and sixty-six intensive care unit（ ICU） patients infected with severe bac terial infections were divided into 2 groups （gram-positive bacteria group and gram-negative bacteria group） according to the bacterial culture results, and serum PCT, C-reaction protein（CRP）, white blood eell（WBC） and neutrophil ratio（Neu%） were detected, and data of two groups were analysed statiscally. Results Serum levels of PCT in patients with severe bacterial infection significantly rose. When defined by the value of PCT ≥2 ng/mL as positive, the positive rate of PCT in gram-negative bacteria group （92. 36%） was significantly higher than that of gram-positive bacteria group （76. 23%）（x2 = 13. 45, P〈0. 001）; When the value of PCT ≥10 ng/mL, the possibility of gram-negative bacterial infection was great. The routine infection markers, including CRP,WBC and Neu% , were not significantly different between gram-positive bacteria group and gram-negative bacteria group（ both P〉0. 05）. Conclusion PCT levels can be used as indicator for differentiating gram-positive and gram-negative bacterial infection, and may provide valuable information for sensitive antimicrobial selection.
出处
《中国感染控制杂志》
CAS
2011年第3期191-193,共3页
Chinese Journal of Infection Control
关键词
降钙素原
细菌感染
革兰阳性菌
革兰阴性菌
诊断
鉴别
儿童
procalcitonin
bacterial infection
gram-positive bacteria
gram-negative bacteria
diagnosis, differen tiate
children
