Li Jiu-Jun, Zhang Tao
Department of Pediatric Intensive Care Unit, Shengjing Hospital of China Medical University, Shenyang, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2013 Mar;15(3):212-5.
To evaluate the diagnostic value of measuring serum C-reactive protein (CRP) and procalcitonin (PCT) levels, within 6 hours after admission to the pediatric intensive care unit (PICU) in children with bloodstream infection (BSI)-associated sepsis and septic infection at other sites.
A retrospective analysis was performed on 30 children with a confirmed diagnosis of systemic inflammatory response syndrome who were admitted to the Shengjing Hospital of China Medical University between January 2010 and January 2012. Clinical data on serum CRP, PCT and D-dimer levels were collected within 6 hours after admission. The diagnostic values of the indices were determined by comparative analysis.
Serum CRP and PCT levels in children with BSI-associated sepsis were significantly higher than in children with septic infection at other sites (P<0.05), but there was no significant difference in serum D-dimer levels between the two groups (P>0.05). Serum PCT level was superior to serum CRP level in distinguishing children with BSI-associated sepsis from those with septic infection at other sites. Serum PCT level could not realistically be used for diagnosing BSI-associated sepsis when it was less than 2 ng/mL (negative predictive value: 100%), but could be reliably used when it was more than 10 ng/mL (positive predictive value: 77%).
Serum PCT level is superior to serum CRP level in distinguishing children with BSI-associated sepsis from those with septic infection at other sites within 6 hours after admission to the PICU. Serum PCT level has a better diagnostic value for BSI-associated sepsis when it is more than 10 ng/mL.
评估在儿科重症监护病房(PICU)收治6小时内,检测血清C反应蛋白(CRP)和降钙素原(PCT)水平对血流感染(BSI)相关脓毒症患儿及其他部位脓毒症感染患儿的诊断价值。
对2010年1月至2012年1月间在中国医科大学附属盛京医院确诊为全身炎症反应综合征的30例患儿进行回顾性分析。收集入院后6小时内血清CRP、PCT和D-二聚体水平的临床资料。通过比较分析确定各项指标的诊断价值。
BSI相关脓毒症患儿的血清CRP和PCT水平显著高于其他部位脓毒症感染患儿(P<0.05),但两组间血清D-二聚体水平无显著差异(P>0.05)。在区分BSI相关脓毒症患儿与其他部位脓毒症感染患儿方面,血清PCT水平优于血清CRP水平。当血清PCT水平低于2 ng/mL时(阴性预测值:100%),实际上不能用于诊断BSI相关脓毒症,但当高于10 ng/mL时(阳性预测值:77%),可可靠用于诊断。
在PICU收治6小时内,血清PCT水平在区分BSI相关脓毒症患儿与其他部位脓毒症感染患儿方面优于血清CRP水平。血清PCT水平高于10 ng/mL时,对BSI相关脓毒症具有更好的诊断价值。