临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (4): 326-.doi: 10.3969 j.issn.1000-3606.2015.04.008

• 综合报道 • 上一篇    下一篇

儿童脓毒症血培养结果与血清降钙素原关系分析

胡方启,程贤高,丁丹,李宗光   

  1. 安徽医科大学附属安庆医院( 安徽安庆 246003)
  • 收稿日期:2015-04-15 出版日期:2015-04-15 发布日期:2015-04-15
  • 通讯作者: 程贤高 E-mail:cxg651240@163.com

The relation of blood culture results of sepsis in children with serum procalcitonin levels 

 HU Fangqi, CHENG Xiangao, DING Dan, LI Zongguang   

  1. Department of Pediatrics, Anqing Affiliated Hospital of Anhui Medical University, Anqing 246003, Anhui, China
  • Received:2015-04-15 Online:2015-04-15 Published:2015-04-15

摘要: 目的 探讨降钙素原(PCT)在判断细菌感染及其种类中的作用。方法 回顾性分析2010年1月至2014年6月确诊为脓毒症的253例患儿的血培养结果与其PCT水平的相关性。结果 253例脓毒症患儿中,血培养阳性124例,阳性率49.01%;其中G+细菌感染71例(28.06%),G细菌感染53例(20.95%)。253例患儿PCT中位水平为1.6(0.4~4.5)ng/ml,其中低(0.05~0.5 ng/ml)、中(~2 ng/ml)、高(~10 ng/ml)、极高组(~300 ng/ml)分别为86例、55例、75例、37例。不同PCT水平组间细菌培养阳性率的差异有统计学意义(χ2=69.14,P<0.01),PCT低水平组细菌培养阳性率最低,其他三组阳性率均高于60%。不同PCT水平组间G+和G菌检出率的差异有统计学意义(P均<0.01),其中,PCT高水平组G+菌检出率最高,而PCT极高水平组G菌检出率最高。结论 PCT对于判断儿童脓毒症是否为细菌感染有一定指导作用,其水平异常升高可考虑革兰阴性细菌感染。

Abstract: Objective To explore the roles of procalcitonin in differentiating bacterial infection from other inflammatory processes and identifying bacterial species. Methods The blood culture results of 253 hospitalized children diagnosed with sepsis from January 2010 to June 2014 were analyzed retrospectively and its relationship with PCT was also analyzed. Results In 253 children with sepsis, the blood culture results of 124 children showed positive (49.01%). There were 71 (28.06%) cases of Gram-positive infection and 53 (20.95%) cases of Gram-negative infection. The median level of PCT in 253 patients was 1.6 (0.4-4.5) ng/ml. According to the PCT levels, all patients were divided into low level group (0.05-0.5 ng/ml, n=86), middle level group (0.5-2.0 ng/ml, n=55), high level group (2.0-10 ng/ml, n=75) and extremely high level group (10-300 ng/ml, n=37). The positive rates of bacterial culture were significantly different among different levels of PCT (χ2=69.14, P<0.01). In low level group the positive rate of bacterial culture was the lowest and in other three groups the positive rate was all above 60%. The detection rate of Gram-positive and Gram-negative bacteria was significantly different among different levels of PCT (P<0.01). In high level group the detection rate of Gram-positive bacteria was the highest while in extremely high level group the rate of Gram-negative bacteria was the highest. Conclusions The level of PCT is helpful for the differentiation of bacterial infection from other inflammatory processes in children with sepsis and abnormally elevated PCT level may indicates Gram-negative infection.