Huo Jun-Ming, Huo Rui, Hu Ling, Lu Si-Wei, Zu Jian
Department of ICU, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China.
Department of Intensive Care Medicine, Chinese Medicine Hospital of Chongqing, Chongqing 402760, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2017 May;48(3):422-426.
To determine the value of procalcitonin (PCT), high sensitivity C-reactive protein (hs-CRP) and pancreatic stone protein(PSP) in predicting the prognosis of children with sepsis.
A total of 106 hospitalized children [(4.4±1.6) year-old] with sepsis were enrolled in this study. The expressions of PTC, hs-CRP and PSP in the serum samples of the children were detected on the first day of admission to hospital. Pearson correlation analyses were performed to test the correlations between pediatric critical illness score (PCIS) and PTC, hs-CRP and PSP. Logistic regression models were established to determine factors predicting death of children. The value of PTC, hs-CRP and PSP in predicting the prognosis of children with sepsis was determined using ROC curves.
About 32% children (34 cases) died. Higher expressions of PTC, hs-CRP and PSP were found in those who died (<0.001). Serum PTC, hs-CRP and PSP were negatively correlated with PCIS (<0.001). The multivariate logistic regression showed that PTC, hs-CRP and PSP were independent predictors of death in patients with sepsis (<0.001). PTC, hs-CRP and PSP had an area under the curve () value of 0.86[ (95% confidence interval (), 0.78-0.92], 0.70 (95%, 0.61-0.79) and 0.69 (95%, 0.60-0.78) , respectively.The value increased (<0.001) to 0.92 (95%, 0.85-0.96) when the three indicators were combined (0.481×PCT+0.392×hs-CRP +0.314*PSP), with a value of less than 122.3 indicating good prognosis in 28 d.
Serum PTC, hs-CRP and PSP can predict prognosis of children with sepsis.
探讨降钙素原（PCT）、高敏C反应蛋白（hs-CRP）及胰石蛋白（PSP）对脓毒症患儿预后的预测价值。
选取106例住院脓毒症患儿[年龄（4.4±1.6）岁]，于入院第1天检测血清PCT、hs-CRP及PSP水平。采用Pearson相关分析检测小儿危重病例评分（PCIS）与PCT、hs-CRP及PSP的相关性。建立Logistic回归模型确定预测患儿死亡的因素。采用ROC曲线评估PCT、hs-CRP及PSP对脓毒症患儿预后的预测价值。
约32%的患儿（34例）死亡。死亡患儿血清PCT、hs-CRP及PSP水平更高（<0.001）。血清PCT、hs-CRP及PSP与PCIS呈负相关（<0.001）。多因素Logistic回归分析显示，PCT、hs-CRP及PSP是脓毒症患儿死亡的独立预测因素（<0.001）。PCT、hs-CRP及PSP的曲线下面积（AUC）分别为0.86[95%置信区间（CI），0.78-0.92]、0.70（95%CI，0.61-0.79）和0.69（95%CI，0.60-0.78）。三者联合检测（0.481×PCT+0.392×hs-CRP +0.314×PSP）时，AUC增大至0.92（95%CI，0.85-0.96），三者联合检测值<122.3提示28 d预后良好。
血清PCT、hs-CRP及PSP可预测脓毒症患儿的预后。
