摘要
目的分析血清降钙素原(PCT)在儿童血流感染抗感染治疗中的应用价值。方法分别检测79例血流感染患儿血培养送检第1、4、7天的PCT,并收集其临床资料。结果共分离出革兰阳性菌37例,革兰阴性菌42例。血培养送检第1天革兰阳性菌和革兰阴性菌PCT水平分别为7.56(5.33～13.49)ng/mL、8.96(5.36～21.34)ng/mL(P>0.05),第4天分别下降至1.10(0.42～3.62)ng/mL、3.41(1.54～9.95)ng/mL(P<0.05),第7天PCT水平分别下降至0.13(0.10～0.34)ng/mL、0.23(0.12～1.92)ng/mL (P<0.05)。不同病原菌PCT水平下降速度不一致,肺炎链球菌下降速度较快,第4天和第7天分别下降了98.57%和99.21%;鲍曼不动杆菌下降速度较慢,第4天和第7天分别下降了33.15%和46.30%。PCT水平的变化与患儿病情转归基本一致。抗菌药物使用时间为17(11.00～22.50)d,革兰阳性菌和革兰阴性菌抗菌药物治疗费分别为206.34(114.00～389.61)元/d和297.29(224.62～502.60)元/d。结论 PCT可以用于评估血流感染治疗中抗菌药物的使用效果。应结合患儿临床实际情况确定使用抗菌药物的时间,并及时调整用药方案,以降低细菌耐药率和不良反应发生率。
Objective To analyze the role of serum procalcitonin(PCT)in the treatment of bloodstream infection in children.Methods Serum PCT of 79 children with bloodstream infection was determined on the 1st,4th and 7th days,respectively,and the clinical data were also collected.Results A total of 37 Gram-positive bacteria and 42 Gram-negative bacteria were isolated.The 1st day PCT of Gram-positive bacteria and 42 Gram-negative bacteria were 7.56(5.33-13.49)ng/mL and 8.96(5.36-21.34)ng/mL,respectively(P>0.05).On the 4th day,PCT in the 2 groups decreased to 1.10(0.42-3.62)ng/mL and 3.41(1.54-9.95)ng/mL,respectively(P<0.05).On the 7th day,PCT decreased to 0.13(0.10-0.34)ng/mL and 0.23(0.12-1.92)ng/mL,respectively(P<0.05).The decreasing rates of PCT differed among different pathogens.Serum PCT of Streptococcus pneumoniae decreased fastly,with 98.57% decreasing on the 4th day and 99.21% decreasing on the 7th day,that of Acinetobacter baumannii decreased slowly,with 33.15% and 46.30% decreasing,respectively.The change of PCT was consistent with the prognosis of children.The antibiotic usage time was 17(11.00-22.50)d.The costs of antibiotics for Gram-positive bacteria and Gram-negative bacteria were 206.34(114.00-389.61)Yuan/d and 297.29(224.62-502.60)Yuan/d,respectively.Conclusions PCT can be used to evaluate the treatment efficiency of antibiotic therapy for bloodstream infection,to adjust the antibiotic usage time and antibiotic therapy timely,which can reduce drug resistance and adverse reactions.
作者
田东兴
潘芬
石迎迎
姜林林
高原
张泓
TIAN Dongxing;PAN Fen;SHI Yingying;JIANG Linlin;GAO Yuan;ZHANG Hong(Department of Clinical Laboratory,Shanghai Children's Hospital,Shanghai Jiaotong University,Shanghai 200040,China)
出处
《检验医学》
CAS
2019年第3期225-228,共4页
Laboratory Medicine
基金
上海市卫生计生委重要薄弱学科建设计划(2015ZB0203)
上海市第四轮公共卫生三年行动计划重点学科项目(15GWZK0101)
关键词
血流感染
降钙素原
儿童
抗菌药物
Bloodstream infection
Procalcitonin
Children
Antibiotic
