Leroy Sandrine, Gervaix Alain
Centre for Statistics in Medicine, Wolfson College Annexe, University of Oxford, Linton Road, Oxford OX2 6UD, UK.
Adv Urol. 2011;2011:397618. doi: 10.1155/2011/397618. Epub 2011 Jan 17.
Urinary tract infections (UTIs) are the most common source of bacterial infections among young febrile children. Accurate diagnosis of acute pyelonephritis (APN) and vesicoureteral reflux (VUR) is important because of their association with renal scarring, leading in the cases to long-term complications. However, the gold standard examinations for both are either DMSA scan (for APN and scar) or cystography (for VUR) and present limitations (feasibility, pain, cost, etc.). Procalcitonin, a reliable marker of bacterial infections, was demonstrated to be a good predictor of both renal parenchymal involvement in the acute phase and late renal scars. Furthermore, it was also found to be associated with high-grade VUR and was the key tool of a clinical decision rule to predict high-grade VUR in children with a first UTI. Therefore, procalcitonin may certainly be found playing a role in the complex and still debated picture of which examination should be performed after UTI in children.
尿路感染（UTIs）是发热儿童中最常见的细菌感染源。准确诊断急性肾盂肾炎（APN）和膀胱输尿管反流（VUR）很重要，因为它们与肾瘢痕形成有关，可导致长期并发症。然而，这两种疾病的金标准检查分别是二巯基丁二酸（DMSA）扫描（用于APN和瘢痕）或膀胱造影（用于VUR），且都存在局限性（可行性、疼痛、成本等）。降钙素原是细菌感染的可靠标志物，已被证明是急性期肾实质受累和晚期肾瘢痕的良好预测指标。此外，还发现它与重度VUR有关，并且是预测首次UTI患儿重度VUR的临床决策规则的关键工具。因此，在儿童UTI后应进行何种检查这一复杂且仍有争议的情况中，降钙素原肯定会发挥作用。
