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目的探讨降钙素原在鉴别革兰阳性菌(G+菌)和革兰阴性菌(G-菌)感染的儿童社区获得性肺炎(CAP)中的作用。方法以2011年1月至2012年12月于四川省人民医院诊断为儿童社区获得性肺炎的住院患者为研究对象,根据痰细菌培养结果将患儿分为G+菌组和G-菌组,比较两组患儿降钙素原(PCT)、超敏C-反应蛋白(hsCRP)和白细胞(WBC)水平的差异。结果共纳入122例儿童CAP患者,其中G+菌感染58例,G-菌感染64例。G-菌感染者外周血PCT水平显著高于G+菌感染者(13.29±4.30 ng/ml vs 7.22±1.07 ng/ml,P<0.001),而hsCRP(12.64±6.20 mg/L vs 13.27±6.90 mg/L,P>0.05)和WBC计数[(11.28±4.30)×109/L vs(12.43±3.70)×109/L,P>0.05]在两组间的分布差异无统计学意义。受试者工作曲线(ROC)分析提示,PCT=7.50 ng/ml时,PCT诊断G-菌感染儿童CAP的ROC曲线下面积为0.846,其敏感度和特异度分别为81.4%和85.6%。结论 PCT对鉴别儿童CAP患者病原菌类型(G+菌或G-菌)具有一定参考价值。
Objective To investigate the role of procalcitonin in the identification of children with community-acquired pneumonia (CAP) infection of Gram-positive bacteria (G +) and Gram-negative bacteria (G- bacteria). Methods From January 2011 to December 2012 in Sichuan Provincial People’s Hospital diagnosed as children with community-acquired pneumonia inpatients as the research object, according to the results of sputum bacterial culture will be divided into G + bacteria group and G-bacteria group, compared Differences in the levels of procalcitonin (PCT), hsCRP and WBC between the two groups. Results A total of 122 children with CAP were enrolled, of which 58 were G + and 64 were G-bacteria. The levels of PCT in peripheral blood of G-infected patients were significantly higher than those of G + infected patients (13.29 ± 4.30 ng / ml vs 7.22 ± 1.07 ng / ml, P <0.001), while the hsCRP (12.64 ± 6.20 mg / L vs 13.27 ± 6.90 mg There was no significant difference in the distribution of WBC between the two groups [(11.28 ± 4.30) × 109 / L vs (12.43 ± 3.70) × 109 / L, P> 0.05) ROC analysis indicated that the area under the ROC curve of CAP was 0.846 for PCT diagnosed children with G-cell infection at PCT = 7.50 ng / ml, with a sensitivity and specificity of 81.4% and 85.6%, respectively. Conclusion PCT has certain reference value for the identification of pathogen types (G + bacteria or G-bacteria) in children with CAP.