摘要
目的分析血清中降钙素原(PCT)在儿童导管相关性血流感染(CRBSI)中的潜在诊断意义。方法选取2017年3月至2018年5月张家口市第一医院收治的留置中心静脉导管儿童以及健康体检儿童为研究对象,根据临床医师诊断分为观察组、对照组和健康组,测量其PCT水平和其他血清标志物水平,并分析CRBSI儿童的病原菌感染情况。结果纳入研究的153例留置中心静脉导管的儿童中,38例诊断为CRBSI,发病率为24.8%;CRBSI病儿PCT水平明显高于对照组(t=2.62,P=0.018)和健康组(t=3.13,P=0.009);CRBSI病儿CRP水平和WBC水平高于健康组(t=2.55,P=0.027;t=2.19,P=0.036),但与对照组相比差异无统计学意义(t=1.65,P=0.058;t=1.51,P=0.077);38例CRBSI病儿中19例(50%)为革兰阳性菌感染,15例(39.5%)为革兰阴性菌感染,剩余4例(10.5%)为真菌感染。且革兰阴性菌感染的CRBSI病儿PCT水平明显高于革兰阳性菌感染者(t=2.57,P=0.023),C反应蛋白(CRP)含量与PCT水平变化一致,WBC水平也存在相同趋势,但组间差异无统计学意义。结论 PCT水平变化监测可能对儿童CRBSI的诊断及感染病原体的鉴别有益。
Objective To discuss the diagnostic significance of serum procalcitonin(PCT)in catheter-related bloodstream infection(CRBSI)of children.Methods Between March 2017 to May 2018,the children in The First Hospital of Zhangjiakou were selected as research objects,and divided into observation group,control group and healthy control group,PCT and other serum marker level were measured,and analyzed the pathogen infection status of CRBSI children.Results 153 children used central venous catheter were included in this research,38 cases diagnosed with CRBSI(24.8%);PCT level in CRBSI children were significantly higher than the control group(t=2.62,P=0.018)and healthy control group(t=3.13,P=0.009);CRP and WBC level in CRBSI children were higher than healthy control group(t=2.55,P=0.027;t=2.19,P=0.036),but had no statistical difference compared with control group(t=1.65,P=0.058;t=1.51,P=0.077);19 cases(50%) were gram-positive bacteria infection,15 cases(39.5%)were gram-negative bacteria infection,4 cases(10.5%)were fungal infection.And PCT level in CRBSI children with gramnegative bacteria infection was significantly higher than gram-positive bacterium infection(t=2.57,P=0.023),the change of CRP level consistent with PCT,the WBC level also had the same trend,but there was no statistically significant difference between the groups.Conclusion Monitoring the change of PCT on children may be good for the diagnosis of CRBSI and the differential diagnosis of infection pathogens.
作者
陈竹雨
CHEN Zhuyu(Department of Clinical laboratory,The First Hospital of zhangjiakou,Zhangjiakou,Hebei 075000,China)
出处
《安徽医药》
CAS
2020年第2期320-322,共3页
Anhui Medical and Pharmaceutical Journal
基金
张家口市科学技术研究与发展计划项目(1521029D)
关键词
导管相关性感染/诊断
感染
C反应蛋白质
降钙素
白细胞计数
血流感染
儿童
Catheter-related infections/diagnosis
Infection
C-reactive protein
Calcitonin
Leukocyte count
Blood-stream infection
Child
