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血清sCD14-ST和PCT对脓毒症患儿感染病原体的诊断价值
作者:陈小琴  李松涛  张淑平  刘丽莎 
单位:南京医科大学附属儿童医院 检验科, 江苏 南京 210024
关键词:可溶性白细胞分化抗原14亚型 降钙素原 脓毒症 病原学 
分类号:R631
出版年·卷·期(页码):2024·43·第三期(373-377)
摘要:

目的:探讨可溶性白细胞分化抗原14亚型(sCD14-ST)和降钙素原(PCT)对脓毒症患儿不同类型病原菌感染的诊断价值。方法:收集 2019年1月至2021年5月南京医科大学附属儿童医院收治的脓毒症患儿98例(脓毒症组),所有病例均符合"脓毒症3.0"诊断标准。根据血培养结果分为革兰阳性球菌组(G+组)、革兰阴性杆菌组(G-组)和血培养阴性组,同时选取90例同期健康体检儿童作为对照组。结果:与对照组儿童相比,脓毒症组患儿血清中sCD14-ST和PCT呈现高表达(P<0.05),且血培养阳性的脓毒症患儿血清中sCD14-ST和PCT的含量均高于血培养阴性患儿(P<0.05)。此外,sCD14-ST对脓毒症患儿血培养阳性的预测价值高于PCT,而PCT对鉴别脓毒症患儿感染G+菌或G-菌的临床预测价值高于sCD14-ST。结论:血清sCD14-ST含量对脓毒症患儿血培养阳性的早期预测价值高于PCT,而PCT对血培养阳性的脓毒症患儿病原菌的感染种类有鉴别价值,表明sCD14-ST和PCT联合检测对脓毒症患儿病原学的诊断具有预测价值。

Objective: To explore the diagnostic value of soluble leukocyte differentiation antigen 14 subtype(sCD14-ST) and procalcitonin(PCT) in children with sepsis with different types of pathogen infction. Methods: A total of 98 children with sepsis(sepsis group) admitted to the Children's Hospital of Nanjing Medical University from January 2019 to May 2021 were collected. All cases were conformed to the diagnostic criteria of sepsis 3.0. According to the results of blood culture, those children were divided into Gram-positive cocci group(G+group), Gram-negative bacilli group(G- group) and blood culture negative group. Meanwhile, 90 healthy children were selected as the control group. Results: Compared with the control group, sCD14-ST and PCT were highly expressed in children with sepsis(P<0.05). The levels of serum sCD14-ST and PCT in children with positive blood culture were higher than those in children with negative blood culture(P<0.05). The predictive value of sCD14-ST for positive blood culture in children with sepsis were higher than that of PCT. Meanwhile, the predictive value of PCT for identificating G-or G+ bacteria in children with sepsis was significantly higher than that of sCD14-ST. Conclusion: The value of sCD14-ST in the early prediction of positive blood culture in children with sepsis is higher than that of PCT, and PCT is valuable for the identification of pathogenic bacteria in children with sepsis. The results show that the combined detection of sCD14-ST and PCT has predictive value in the diagnosis of etiology in children with sepsis.

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