摘要
目的 探讨严重脓毒症患儿血清白蛋白(ALB)、降钙素原(PCT)与危重度及预后的关系。方法 回顾性分析2017年11月至2020年11月间西安市儿童医院收治的110例严重脓毒症患儿的临床资料,根据儿童危重病例评分(PCIS)标准,将其分为非危重组(36例,PCIS>80分)、危重组(50例,PCIS为71~80分)、极危重组(24例,PCIS≤70分)。患儿入院24h内检测血清ALB、PCT水平,比较三组患儿的ALB、PCT水平差异,并采用Pearson对ALB、PCT与PCIS评分进行相关性分析。对所有患儿均予以积极治疗,根据治疗结局将其分为存活组(86例)、死亡组(24例),采用受试者工作特征(ROC)曲线分析ALB、PCT及其联合检测对严重脓毒症患儿预后的预测价值。结果 非危重组、危重组、极危重组患儿的血清ALB和PCT水平及PCIS评分比较差异均有统计学意义(F值分别为96.809、189.079、430.255,P<0.05)。危重组、极危重组患儿的血清ALB水平及PCIS评分均低于非危重组(t值分别为9.127、25.542、12.551、22.640,P<0.05),血清PCT水平均高于非危重组(t值分别为11.594、18.726,P<0.05);极危重组患儿的血清ALB水平及PCIS评分均低于危重组(t值分别为6.656、15.737,P<0.05),血清PCT水平高于危重组(t=10.760,P<0.05)。Pearson相关性分析显示,血清ALB与PCT呈显著负相关(r=-0.576,P<0.01);血清ALB与PCIS评分呈显著正相关(r=0.814,P<0.01),而血清PCT与PCIS评分呈显著负相关(r=-0.743,P<0.01)。死亡组患儿的血清ALB水平低于存活组(t=8.961,P<0.05),而PCT水平高于存活组(t=17.406,P<0.05)。ROC曲线分析显示,血清ALB、PCT对严重脓毒症患儿预后具有一定的预测价值,曲线下面积分别为0.836、0.887,P<0.01;两项联合检测的预测价值较高,曲线下面积为0.901,P<0.01。结论 严重脓毒症患儿的血清ALB与PCT呈显著负相关,ALB水平越低、PCT水平越高,患儿的危重度越高,联合检测血清ALB、PCT可作为预测患儿预后的有效方法。
Objective To explore the relationship between serum albumin(ALB),procalcitonin(PCT) and criticality and prognosis in children with severe sepsis.Methods The clinical data of 110 children with severe sepsis admitted to Xi′an Children′s Hospital between November 2017 and November 2020 was retrospectively analyzed.According to the pediatric critical illness score(PCIS) criteria, divided them into non-critical group(36 cases, PCIS>80 points),critical group(50 cases, PCIS 71~80 points),extremely critical group(24 cases, PCIS≤70 points).Serum ALB and PCT levels were detected within 24 hours.The differences in ALB and PCT levels of the three groups were compared, and the relationship between ALB,PCT and PCIS scores were analyzed by Pearson correlation.All children were actively treated.According to their treatment outcomes, they were divided into survival group(86 cases) and death group(24 cases),The predictive value of ALB,PCT and their combined detection in the prognosis of sepsis in children was analyzed by receiver operating characteristic(ROC) curve.Results There were statistically significant differences in the serum ALB,PCT and PCIS scores of the three groups in children(F=96.809,189.079 and 430.255,respectively, P<0.05).The serum ALB and PCIS scores in critical group and extremely critical group were lower than non-critical group(t=9.127,25.542,12.551 and 22.640,respectively, P<0.05),and serum PCT levels were higher than non-critical group(t=11.594 and 18.726,respectively, P<0.05);The serum ALB and PCIS scores in extremely critical group were lower than critical group(t=6.656 and 15.737,respectively, P<0.05),and serum PCT was higher than critical group(t=10.760,P<0.05).Pearson correlation analysis showed that serum ALB was significantly negatively correlated with PCT(r=-0.576,P<0.01);Serum ALB was significantly positively correlated with PCIS score(r=0.814,P<0.01),while serum PCT was significantly negatively correlated with PCIS(r=-0.743,P<0.01).The serum ALB level of the children in death group was lower
作者
武秀梅
马英
乔晓霞
李园园
陈晨
汪利群
WU Xiumei;MA Ying;QIAO Xiaoxia;LI Yuanyuan;CHEN Chen;WANG Liqun(Xi′an Children′s Hospital,Shaanxi Xi′an 710003,China)
出处
《中国妇幼健康研究》
2022年第5期107-111,共5页
Chinese Journal of Woman and Child Health Research
关键词
严重脓毒症
患儿
白蛋白
降钙素原
危重度
预后
severe sepsis
children patient
albumin
procalcitonin
criticality
prognosis
