首页> 中文期刊> 《临床儿科杂志》 >降钙素原监测对重症患儿抗菌药物使用的指导意义

降钙素原监测对重症患儿抗菌药物使用的指导意义

         

摘要

Objective To discuss the clinical value of procalcitonin (PCT) in guiding antibiotics use in children with severe diseases. Methods The clinical data of patients admitted to intensive care unit from January 2012 to July 2012 were retrospectively analyzed. The patients without antibiotics use before admission and with procalcitonin level less than 0.5 ng/ml on admission were selected. The body temperature, infection indicators and prognosis were compared between patients with and without antibiotics use during hospitalization. Results There was no difference in body temperature, PCT, C-reactive pro-tein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) on admission between patients with and without antibiotics use during hospitalization. The PCT level was increased signiifcantly (P<0.05) on the day of starting the an-tibiotics when compared with that on admission in 60 patients while there was no change in the levels of WBC and CRP. Com-pared with the day of starting the antibiotics, body temperature declined (P<0.05) and PCT level in 56 patients reexamined was decreased (P<0.05) at 3 days after antibiotics use. Two hundred and eleven patients (98.14%) had favorable prognosis. Conclu-sions Monitoring PCT can guiding the clinical use of antibiotics.%目的:探讨降钙素原(PCT)在指导重症患儿抗菌药物使用方面的临床价值。方法回顾性分析自2012年1月至7月215例重症监护病房患儿的临床资料。以入院时PCT≤0.5 ng/ml,且入院前未使用抗菌药物的患儿作为研究对象;比较在住院期间一直未使用抗菌药物及使用抗菌药物患儿的体温、临床相关感染指标变化及预后情况。结果住院期间155例一直未使用抗菌药物与60例使用抗菌药物患儿相比较,入院时体温以及PCT、C-反应蛋白、红细胞沉降率、白细胞计数等感染指标的差异均无统计学意义。60例使用抗菌药物患儿,在抗菌药物使用当天PCT水平较入院时有明显升高,差异有统计学意义(P<0.05),而白细胞计数、C反应蛋白水平则无明显改变;用药3 d后,使用抗菌药物患儿的体温较用药当天明显下降,差异有统计学意义(P<0.05),其中56例患儿复查PCT,较用药当天明显降低,差异有统计学意义(P<0.05)。211例(98.14%)患儿预后良好。结论监测PCT可指导临床抗菌药物的使用。

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