降钙素原与 C 反应蛋白联合评分系统在儿童急性腹泻抗菌治疗中的应用

Application of joint procalcitonin and C-reactive in antibiotic treatment of children acut diarrhea

摘要:

目的??探讨降钙素原与 C 反应蛋白联合评分系统应用于儿童急性腹泻抗菌治疗的合理性。方法 前瞻性收集江西省儿童医院新收治的急性腹泻患儿，无典型细菌性腹泻表现但被上述评分系统判为阳性，随 机分为实验组和对照组，每组 15 例。实验组使用抗生素，对照组不使用抗生素，共观察 5?d，比较两组的治疗 有效率、 典型细菌性腹泻的发生率、 病死率及不良事件率。结果??实验组第 5 天的治疗有效率优于对照组 （93.3% Vs?46.6%） ， 差异有统计学意义（ P ?<0.05） 。两组典型细菌性腹泻的发生率相当， 差异无统计学意义（ P ?>0.05） ， 无死亡及不良事件发生。结论??降钙素原与 C 反应蛋白联合评分系统对儿童急性腹泻的抗菌治疗具有一定的 指导意义， 针对无典型细菌性腹泻表现但被该系统判为阳性的急性腹泻患儿， 抗生素治疗可使其受益。

Abstract:

Objective To investigate the rationality of antibiotic treatment for children with acute diarrhea under instruction of a joint score system of procalcitonin and C-reactive protein. Methods In Jiangxi Provincial Children’s Hospital, new hospitalized acute diarrhea children without typical manifestation of bacterial diarrhea who were judged to be positive ones by the joint system were involved and divided into test group (n = 150) and control group (n = 15). All patients received standard treatment while patients in test group received additional antibiotics. Response rates, incidence rates of typical bacterial diarrhea, mortality and adverse event rates were recorded. Results On day 5, therapeutic response rates were increased significantly in test group compared with control group (93.3% VS 46.6%, P < 0.05). The incidence rates of typical bacterial diarrhea between the two groups were similar (P > 0.05). No death or adverse event occurred. Conclusions The joint score system combined with procalcitonin and C-reactive protein could provide guidance for antibiotic treatment of acute diarrhea children without typical manifestation of bacterial diarrhea.