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目的：探讨脓毒症患儿血清降钙素原（PCT）水平变化及临床应用价值。方法：对脓毒症组38 例患儿（严重脓毒症组16 例、非严重脓毒症组22 例）血清PCT、C 反应蛋白（CRP）水平和白细胞（WBC）计数等指标进行检测，并与非脓毒症组的40 例患儿进行比较分析。结果：脓毒症组患儿血清PCT、CRP 水平及WBC 计数均显著高于非脓毒症组，差异具有统计学意义（P<0.05）；血清 PCT、CRP 水平对诊断脓毒症的敏感性差异无显著性（P>0.05），均显著高于WBC 计数，差异具有统计学意义（P<0.05）；血清PCT 水平特异性、阳性预测值、阴性预测值及约登指数均显著高于CRP 和WBC 计数，差异具有统计学意义（P<0.05）；严重脓毒症组患儿血清PCT 水平显著高于非严重脓毒症组，差异具有统计学意义（P<0.05），而两组间血清CRP 水平及WBC 计数差异不显著（P>0.05）。结论：PCT 可作为敏感性的鉴别诊断患儿脓毒症的血清学指标，其效果优于CRP 和WBC 计数。

英文摘要:

Objective: To explore the clinical significance of detecting the serum procalcitonin (PCT) level in children with sepsis. Methods: The serum PCT levels, C-reactive protein (CRP) levels and white blood cell (WBC) count were detected in 38 patients (16 children with severe sepsis, 22 children with non-severe sepsis), and compared with 40 children without sepsis. Results: The serum PCT levels, CRP and WBC count in the sepsis group were significantly higher than non-sepsis group, the difference was statistically significant (P<0.05). The sensitivity of PCT, CRP in the diagnosis of sepsis wasn't statistically significant (P>0.05), but it was significantly higher than WBC count, the difference was statistically significant (P<0.05). The specificity, positive predictive value, negative predictive value, Youden index of PCT were significantly higher than CRP and WBC count, the difference was statistically significant (P<0.05); The serum PCT level in the severe sepsis group was significantly higher than that non-severe sepsis group, the difference was statistically significant (P<0.05), but the serum levels of CRP and WBC count had no significant difference between the two groups (P>0.05). Conclusions: PCT could be used as a sensitive serum marker in diagnosing sepsis in children. The effect of PCT is superior to CRP and WBC count.

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