Desmarest M, Aupiais C, Le Gal J, Tourteau L, Le Coz J, de Paepe E, Titomanlio L, Faye A
Service d'accueil des urgences pédiatriques, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France.
Hôpital Robert-Debré, unité d'épidémiologie clinique, AP-HP, 75019 Paris, France; Université Denis-Diderot-Paris-7, Sorbonne-Paris-Cité, Paris, France; Inserm, U1123, ECEVE and CIC-EC 1426, 75019 Paris, France.
Arch Pediatr. 2017 Nov;24(11):1060-1066. doi: 10.1016/j.arcped.2017.08.023. Epub 2017 Oct 4.
Very few studies have evaluated the role of procalcitonin (PCT) in infants with bronchiolitis.
To describe infants who had both a diagnosis of bronchiolitis at the emergency department and a blood test including PCT, and to compare the characteristics of children according to the PCT value.
Infants admitted to the Pediatric Emergency Department between 1 January 2014 and 31 December 2014 who had a diagnosis of bronchiolitis and a blood test including PCT were included. The clinical, biological, and radiological characteristics of the infants with PCT <1 or ≥1g/L were compared.
One hundred thirty six infants were included. Patients with high PCT (n=20) had a higher temperature (38.5°C, IQR=37.8-38.6 vs. 37.5°C, IQR=37.1-38.2; P<0.01), C-reactive protein (50mg/L, IQR=25-83 vs. 5mg/L, IQR=0-19; P<0.01), and neutrophils (7.8×10/L, IQR=6.0-8.5 vs 4.5×10/L, IQR=2.9-6.6; P<0.01) higher than patients with low PCT (n=116). Presence on the chest x-ray of alveolar condensation did not differ between the two PCT groups. Infants coming from the low-PCT group received fewer antibiotics (14.7% vs 65%; P<0.01).
In a Pediatric Emergency Department, PCT with a value of 1 or more cannot predict the presence of alveolar condensation on the chest x-ray. It seems to be associated with the antibiotics prescription, even if this could not be proved because of the design of the study.
极少有研究评估降钙素原(PCT)在毛细支气管炎婴儿中的作用。
描述在急诊科被诊断为毛细支气管炎且进行了包括PCT在内的血液检查的婴儿,并根据PCT值比较儿童的特征。
纳入2014年1月1日至2014年12月31日期间入住儿科急诊科、被诊断为毛细支气管炎且进行了包括PCT在内的血液检查的婴儿。比较PCT<1或≥1μg/L的婴儿的临床、生物学和放射学特征。
共纳入136名婴儿。PCT值高的患者(n=20)体温更高(38.5°C,四分位间距[IQR]=37.8-38.6,而37.5°C,IQR=37.1-38.2;P<0.01)、C反应蛋白更高(50mg/L,IQR=25-83,而5mg/L,IQR=0-19;P<0.01)以及中性粒细胞更高(7.8×10⁹/L,IQR=6.0-8.5,而4.5×10⁹/L,IQR=2.9-6.6;P<0.01),高于PCT值低的患者(n=116)。两组PCT患者胸部X光片上肺泡实变的情况无差异。来自PCT值低组的婴儿接受抗生素治疗的较少(14.7%对65%;P<0.01)。
在儿科急诊科,PCT值为1或更高不能预测胸部X光片上肺泡实变的存在。它似乎与抗生素处方有关,尽管由于研究设计无法证实这一点。