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目的探讨血清降钙素原(PCT)在全身炎症反应综合征(SIRS)患儿中的变化及应用价值。方法选择PICU收治的符合SIRS诊断标准的危重病患儿80例及健康对照80例,其中SIRS患儿依据是否并多器官功能障碍(MODS)分为MODS组(20例)和非MODS组(60例);依据原发病病因分为细菌感染组(60例)和非细菌感染组(20例);依据预后分为死亡组(12例)和存活组(68例)。入院24 h内检测PCT和CRP水平,并进行统计学分析。结果 SIRS患儿血清PCT、CRP水平明显高于健康对照组;细菌感染组血清PCT水平较非细菌感染组明显增高(P<0.05),2组间血清CRP水平比较差异无统计学意义(P>0.05);MODS组血清PCT明显高于非MODS组(P<0.01),2组间血清CRP水平比较差异无统计学意义(P>0.05);死亡组血清PCT明显高于存活组(P<0.05),2组间血清CRP水平比较差异无统计学意义(P>0.05)。SIRS患儿血清PCT水平与简化PCIS评分呈显著负相关,随着PCIS评分降低,血清PCT水平升高。结论血清PCT水平较CRP能更特异的反映全身炎症反应及疾病的预后。
Objective To investigate the changes and clinical value of serum procalcitonin (PCT) in children with systemic inflammatory response syndrome (SIRS). Methods Eighty critically ill patients with SIRS and 80 healthy controls were enrolled in this study. The children with SIRS were divided into MODS group (20 cases) and non-MODS group (60 cases) according to whether they had multiple organ dysfunction (MODS) The patients were divided into bacterial infection group (n = 60) and non-bacterial infection group (n = 20) according to the cause of primary disease. According to the prognosis, they were divided into death group (12 cases) and survival group (68 cases). PCT and CRP levels were measured within 24 h of admission and statistical analysis was performed. Results The levels of serum PCT and CRP in children with SIRS were significantly higher than those in healthy controls. The levels of serum PCT in bacterial infection group were significantly higher than those in non-bacterial group (P <0.05), while there was no significant difference in serum CRP levels between the two groups (P> 0.05). The serum PCT in MODS group was significantly higher than that in non-MODS group (P <0.01). There was no significant difference in serum CRP levels between the two groups (P> 0.05) ). There was no significant difference in serum CRP levels between the two groups (P> 0.05). There was a significant negative correlation between serum PCT level and simplified PCIS score in children with SIRS. Serum PCT level increased with the decrease of PCIS score. Conclusion Serum PCT levels more specifically reflect the systemic inflammatory response and disease prognosis than CRP.