Objective To compare and analyze serum levels of procalcitonin (PCT) of children with viral and bacterial infection and probe into the importance of determining the level of serum PCT in the diagnosis of bacterial infection in order to provide evidences of the clinical use of antibiotics.
Methods A total of 85 cases of children with an average age of 8.9 years (10 months-12 years) were enrolled in this study, 53 cases were with viral infection and 32 cases with bacterial infection. We determined serum levels of PCT by semi-quantitative solid phase immunoassay, and the serum levels of PCT were divided into four grades as<0.5μg/L,≥ 0.5μg/L,≥2.0μg/L and≥10μg/L forχ2 test and Ridit analysis.
Results The serum level of PCT of the group with bacterial infection were signiifcantly higher than that of the group with viral infection (P<0.001). The sensitivity of diagnosis of bacterial infection in children with determination of serum levels of PCT was 87.50%while the speciifcity was 92.13%, and positive predictive value was 73.68%while negative predictive value was 91.49%, and positive likelihood ratio was 4.65 while negative likelihood ratio was 0.15, and the diagnostic accuracy was 83.53%.
Conclusions Serum PCT is a bacterial sensitive marker of bacterial infection in children, and the determination of the level of serum PCT is helpful for the diagnosis of bacterial infection, which can also be a basis for the use of antibiotics.

血清PCT联合CRP测定在支气管哮喘急性发作期合并细菌感染的临床意义

目的：探讨血清降钙素原(PCT)联合C-反应蛋白(CRP)测定在支气管哮喘急性发作期并细菌感染中的诊断价值。方法本研究观察87例住院支气管哮喘急性发作期患者，入院当天治疗前测定血清PCT及CRP水平，并进行痰液细菌学培养和胸部影像学等检查。根据临床特征、实验室、痰液细菌学培养以及影像学检查结果，将支气管哮喘急性发作期患者分为细菌感染组和非细菌感染组。比较两组患者治疗前血清PCT、CRP水平及治疗后变化。结果在急性加重期，细菌感染组血清PCT及CRP水平显著高于非细菌感染组(P＜0.01)。治疗后两组患者血清PCT及CRP水平比较差异无统计学意义(P＞0.05)。结论血清PCT联合CRP测定可协助判断支气管哮喘急性发作期患者是否合并细菌感染。血清PCT、CRP水平高低可作为是否使用抗菌药物的参考依据。

多种生物标志物在脓毒症患者中的临床价值

目的:通过联合检测脓毒症患者血浆氨基末端脑钠肽前体(NT-proBNP)、降钙素原、乳酸及胆碱酯酶的质量浓度,研究其对脓毒症患者病情评估及预后判断的临床意义.方法:用前瞻性研究方法,以2015-01-2017-06期间在我院重症监护室住院的120例脓毒症患者为研究对象.其中一般脓毒症组51例,严重脓毒症组40例,脓毒症休克组29例.对3组患者不同时间NT-proBNP、降钙素原、乳酸及胆碱酯酶质量浓度水平变化进行比较分析,并行APACHEⅡ评分.随访严重脓毒症及脓毒症休克组患者28 d生存情况,对存活组(50例)及死亡组(19例)患者的各项指标进行比较,并比较NT-proBNP、降钙素原、乳酸、胆碱酯酶与APACHEⅡ评分的相关性.结果:与脓毒症组患者相比,严重脓毒症组和脓毒症休克组患者在不同时间血浆NT-proBNP、降钙素原、乳酸水平明显提高,而胆碱酯酶明显降低,3组间比较差异均具有统计学意义(P＜0.05);与严重脓毒症组相比,脓毒症休克组患者在不同时间血浆NT-proBNP、降钙素原、乳酸水平明显提高,而胆碱酯酶明显降低,3组间比较差异均具有统计学意义(P＜0.05);与存活组相比,死亡组血浆NT-proBNP、降钙素原、乳酸质量浓度及A-PACHEⅡ评分均明显提高,而胆碱酯酶水平明显降低,差异具有统计学意义(P＜0.05);血浆NT-proBNP、降钙素原、乳酸质量浓度与APACHEⅡ评分呈正相关,胆碱酯酶的质量浓度与APACHEⅡ评分呈负相关.结论:血浆NT-proBNP、降钙素原、乳酸、胆碱酯酶联合检测对于脓毒症患者预后的评估具有重要的临床指导意义.