降钙素原和 C 反应蛋白在儿童脓毒症或脓毒性休克早期诊断中的比较。
Comparison between procalcitonin and C-reactive protein for early diagnosis of children with sepsis or septic shock.
机构信息
Pediatrics Department, Botucatu Medical School, Sao Paulo State University, São Paulo, Brazil.
出版信息
Inflamm Res. 2010 Aug;59(8):581-6. doi: 10.1007/s00011-010-0161-0. Epub 2010 Feb 4.
OBJECTIVE AND DESIGN
The objective of the paper is to examine the behavior of C-reactive protein (CRP) and procalcitonin (PCT) in the first 12 h of admission and verify which performs better to differentiate children with septic conditions.
SUBJECTS
Septic children aged between 28 days and 14 years were divided into sepsis (SG; n = 46) and septic shock (SSG; n = 41) groups. CRP and PCT were measured at admission (T0) and 12 h later (T12 h). PCT results were classed as: 0.5 ng/ml = sepsis unlikely; >or=0.5 to <2 = sepsis possible; >or=2 to <10 = systemic inflammation; >or=10 = septic shock.
RESULTS
At T0, there was a higher frequency of SSG with PCT >10 compared to SG [SSG: 30 (73.1%) > SG: 14 (30.4%); P < 0.05]. Similar results were observed at T12 h. Pediatric Risk of Mortality I score was significantly higher for SSG patients with higher PCT than SG patients. CRP levels were not statistically different for groups and time points.
CONCLUSIONS
PCT was better than CRP for diagnosing sepsis and septic shock, mainly at admission, and is related to disease severity.
目的和设计
本文旨在研究 C 反应蛋白（CRP）和降钙素原（PCT）在入院后 12 小时内的行为，并验证哪种方法更能区分患有脓毒症的儿童。
受试者
年龄在 28 天至 14 岁之间的脓毒症儿童分为败血症（SG；n = 46）和败血症休克（SSG；n = 41）组。在入院时（T0）和 12 小时后（T12 h）测量 CRP 和 PCT。PCT 结果分为：0.5ng/ml=败血症可能性低；>或=0.5 至 <2=败血症可能；>或=2 至 <10=全身炎症；>或=10=败血症休克。
结果
在 T0 时，与 SG 相比，SSG 中 PCT > 10 的频率更高[SSG：30（73.1%）>SG：14（30.4%）；P < 0.05]。在 T12 h 时也观察到了类似的结果。PCT 较高的 SSG 患儿的儿科死亡风险 I 评分显著高于 SG 患儿。CRP 水平在各组和各时间点均无统计学差异。
结论
PCT 比 CRP 更能诊断败血症和败血症休克，主要在入院时，并且与疾病严重程度相关。
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