摘要
目的探讨血清降钙素原(PCT)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体(D-D)、纤维蛋白原(FIB)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)以及凝血酶原时间(PT)在儿童脓毒症早期诊断中的价值。方法选取2020年6月—2023年6月湖南医药学院总医院儿童重症监护病房(PICU)收治的脓毒症患儿82例为脓毒症组,同期普通病房呼吸道感染患儿90例为普通感染组,儿童保健科健康体检儿童100例为对照组。比较各组血清PCT、AT-Ⅲ、D-D、FIB、TT、APTT、PT水平。结果与普通感染组、对照组比较,脓毒症组血清PCT、D-D升高,凝血4项中TT、APTT、PT延长,AT-Ⅲ、FIB水平降低,差异均有统计学意义(P<0.05)。血清PCT、AT-Ⅲ、D-D、PT、APTT、TT、FIB水平诊断儿童脓毒症的曲线下面积分别为0.949、0.174、0.911、0.869、0.855、0.834、0.242,其中血清PCT的诊断价值最高,其截点值为0.62μg/L时的约登指数最大,诊断灵敏度、特异度分别为86.6%、79.0%;7项指标联合诊断儿童脓毒症的曲线下面积为0.966。结论血清PCT、AT-Ⅲ、D-D及凝血4项水平检测对脓毒症患儿的早期诊断、鉴别诊断有重要价值。
Objective To investigate the values of serum procalcitonin(PCT),anti-thrombinⅢ(AT-Ⅲ),D-dimer(D-D),fibrinogen(FIB),thrombin time(TT),activated partial thromboplastin time(APTT),and prothrombin time(PT)in the early diagnosis of pediatric sepsis.Methods A total of 82 children with sepsis in the Pediatric Intensive Care Unit(PICU)of General Hospital of Hunan University of Medicine from June 2020 to June 2023 were selected as sepsis group.Meanwhile,90 children with respiratory tract infections in the general ward were included in general infection group,and 100 healthy children in the Department of Pediatric Health were selected as control group.The levels of serum PCT,AT-Ⅲ,D-D,FIB,TT,APTT and PT were compared among the three groups.Results Compared with the general infection group and the control group,the sepsis group had significantly higher serum PCT and D-D levels,prolonged TT,APTT and PT in the four-items of coagulation test,and reduced AT-Ⅲand FIB levels(P<0.05).The areas under the curve(AUCs)for the diagnosis of pediatric sepsis by serum PCT,AT-Ⅲ,D-D,PT,APTT,TT and FIB levels were 0.949,0.174,0.911,0.869,0.855,0.834 and 0.242 respectively;among these indexes,serum PCT showed the highest diagnostic value,with the maximum Youden index at a cut-off value of 0.62μg/L,and the diagnostic sensitivity and specificity were 86.6%and 79.0%respectively.The AUC for the combined diagnosis of pediatric sepsis by the seven indicators was 0.966.Conclusion The detection of serum PCT,AT-Ⅲ,D-D and four items of coagulation test is of great value in the early diagnosis and differential diagnosis of pediatric sepsis.
作者
张琼
罗启林
王凯
ZHANG Qiong;LUO Qilin;WANG Kai(Department of Pediatrics,General Hospital of Hunan University of Medicine,Huaihua,Hunan,418000)
出处
《实用临床医药杂志》
CAS
2024年第21期43-47,共5页
Journal of Clinical Medicine in Practice
基金
湖南省儿科医联体专项科研基金(202003220056)。
