标题：降钙素原和C反应蛋白水平变化的研究

      作者：王自财，张小莉，黄循斌，吴 伟，林奕浩，周曙明
    （深圳市龙岗中心医院儿科，广东 深圳 518116）

      卷次： 2013年24卷11期

      【摘要】 目的 观察脓毒症患儿血浆可溶性髓系细胞触发受体1 (sTREM-1)、降钙素原（PCT）和C反应蛋
白（CRP）水平的变化及意义。方法 采用ELIAS法检测65例脓毒症患儿和25例非脓毒症患儿的血浆 sTREM-1
和PCT水平，采用免疫比浊法测定CRP水平，采用小儿危重病例评分（PCIS）评价脓毒症患儿的严重程度，并分析
各指标间的相关性。结果 脓毒症患儿血浆中 sTREM-1、PCT、CRP水平和PCIS评分显著高于对照(P<0.05)，脓
毒症患儿不同亚组间的 sTREM-1和PCT水平比较差异有统计学意义(P<0.05)，而CRP水平比较差异无统计学意
义(P>0.05)；sTREM-1、PCT和CRP对脓毒症诊断的曲线下面积(AUC)分别为0.902，0.845和0.671；生存组患儿的
血浆 sTREM-1、PCT水平随时间推移逐渐下降，死亡组在各时间点差异无统计学意义，第4天和第7天显著高于
生存组(P<0.05)；两组患儿的血浆CRP水平在各时间点均差异无统计学意义(P>0.05)；脓毒症患儿的 sTREM-1、
PCT和 PCIS评分两两之间均呈正相关 (P<0.05)；CRP与以上各指标均无明显相关性 (P>0.0)。结论 血浆
sTREM-1和PCT水平是脓毒症患儿早期诊断的较好指标，在判断病情严重程度及预后方面均优于CRP。

      【关键词】 脓毒症；可溶性髓样细胞触发受体1；降钙素原；C反应蛋白

      【中图分类号】 R726 【文献标识码】 A 【文章编号】 1003—6350（2013）11—1625—04


Research of plasma soluble triggering receptor expressed on myeloid cells-1, PCT and CRP levels in children
with sepsis.
WANG Zi-cai, ZHANG Xiao-li, HUANG Xun-bin, WU Wei, LIN Yi-hao, ZHOU Shu-ming. Department of
Pediatrics, the Central Hospital of Longgang District of Shenzhen City, Shenzhen 518116, Guangdong, CHINA

【Abstract】 Objective To observe the levels and clinical significance of plasma soluble triggering receptor
expressed on myeloid cells-1 (sTREM-1), procalcitonin (PCT) and C-reactive protein (CRP) in children with sepsis.
Methods Plasma concentration of sTREM-1, PCT and CRP were measured by ELISA, and CRP level was detected
by immunoturbidimetry in 65 children with sepsis and 20 children without sepsis. The pechatdc critical illnesss score
(PCIS) was used to evaluate the severity of sepsis. The relationship between each index was analyzed respectively.
Results Plasma levels of sTREM-1, PCT and CRP and PCIS of children with sepsis were significantly higher than
those in the control group (P<0.05). The levels of sTREM-1 and PCT showed statistically significant difference be-
tween subgroups of sepsis (P<0.05), but there was no significant difference of CRP levels between the subgroups (P>
0.05). The area under the curve (AUC) for sTREM-1, PCT and CRP were 0.902, 0.845 and 0.671. Plasma concentra-
tion of sTREM-1 and PCT decreased in survival group and hold stationary in death group during the seven days peri-
od of study, and sTREM-1 in survival group was higher than death group at the fourth and seventh day. There was no
significant difference of CRP levels between all time points. There were significantly positive correlations between
sTREM-1, PCT and PCIS (P<0.05), while no relationship between CRP and others (P>0.05). Conclusion Plasma
sTREM-1 and PCT levels are good indicators of the early diagnosis of sepsis in children, which may be better than
CRP in evaluating the severity of the disease and the prognosis.