外周血内PCT、CRP水平对小儿急性腹泻采取抗生素治疗的指导效果评价

张芝艳

[摘要] 目的 考察外周血內降钙素原（procalcitonin，PCT）、C反应蛋白（C-reactive protein，CRP）水平对小儿急性腹泻采用抗生素治疗的指导效果评价。 方法 采集2016年8月～2019年12月于我院诊治的急性腹泻患儿60例，PCT与CRP联合评分≥0.52均为阳性，根据时间顺序随机分为观察组和对照组，每组30例，对照组患者不应用抗生素，观察组患者给予抗生素，比较两组患儿外周血PCT、CRP的水平及二者联合评分、明显黏液脓血便率、大便细菌阳性率及临床治疗有效率。 结果 观察组和对照组患儿在外周血PCT、CRP及二者联合评分上相比，差异无统计学意义（P>0.05）;相比于对照组，观察组患儿的明显黏液脓血便率显著降低，差异具有统计学意义（P<0.05），大便细菌阳性率相比，差异无统计学意义（P>0.05）;观察组患儿的临床治疗有效率显著高于对照组，差异具有统计学意义（P<0.05）。 结论 外周血内PCT、CRP水平对于无典型症状的小儿急性腹泻抗生素的早期应用具有指导意义，治疗效果良好。

[关键词] 小儿急性腹泻;抗生素;降钙素原;C反应蛋白

[中图分类号] R725.7          [文献标识码] B          [文章编号] 1673-9701（2020）16-0063-04

Evaluation of the guiding effect of PCT and CRP levels in peripheral blood on antibiotic treatment for acute pediatric diarrhea

ZHANG Zhiyan

Department of Pediatric Internal Medicine， Changzhou Childrens Hospital， Nantong University， Changzhou   213000， China

[Abstract] Objective To investigate the evaluation of the guiding effect of procalcitonin（PCT） and C-reactive protein（CRP） levels in peripheral blood on the antibiotic treatment of acute pediatric diarrhea. Methods A total of 60 children patients with acute diarrhea who were diagnosed and treated in our hospital from August 2016 to December 2019 were collected. The combined score of PCT and CRP of ≥0.52 was considered positive. The patients were randomly divided into an observation group and a control group according the time order， with 30 cases in each group. Patients in the control group were not given antibiotics， and patients in the observation group were given antibiotics. The levels of PCT and CRP in the peripheral blood and their combined scores， the rate of obvious mucous pus and blood stools， the positive rate of stool bacteria， and the clinical efficacy were compared between the two groups of children patients. Results There was no statistically significant difference in peripheral blood PCT， CRP and their combined score between the observation group and the control group（P>0.05）; compared with the control group， the rate of obvious mucous pus and blood stools in the observation group was significantly reduced， and the difference was statistically significant（P<0.05）. The positive rate of stool bacteria was compared， and the difference was not statistically significant（P>0.05）; the clinical efficacy in the observation group was significantly higher than that in the control group， and the difference was statistically significant（P<0.05）. Conclusion The levels of PCT and CRP in peripheral blood are of guiding significance for the early application of antibiotics in the treatment of pediatric acute diarrhea without typical symptoms， and the therapeutic effect is considered favorable.

[Key words] Pediatric acute diarrhea; Antibiotics; Procalcitonin（PCT）; C-reactive protein

小儿急性腹泻以大便性状改变及大便次数增多为特点，是儿童死亡的重要因素之一，临床上大便细菌培养是诊断细菌性腹泻的金标准，但检查耗时较长，而患儿的免疫力相对较低，若不能早期明确诊断，易导致病情延误，预后较差[1-2]。抗生素的早期合理应用有助于缩短患儿病程，效果明显，临床上针对症状较为典型的腹泻患儿可根据指南给予抗生素治疗，而针对不典性症状的腹泻患儿，早期明确诊断较为困难，故而需要依靠其他指标辅助诊断，既往临床研究发现降钙素原和C反应蛋白对于腹泻具有一定的诊断意义[3-4]，因而，本研究探讨外周血PCT、CRP水平对小儿急性腹泻采用抗生素治疗的指导效果评价。