Clinical Observation of Plasma Procalcitonin in Guiding Pediatric Systemic Inflammatory Response Syndrome Antibacterial Drug Therapy

doi:10.3877/cma.j.issn.1673-5250.2014.04.018

Objective

To study the clinical effects and significance of plasma procalcitonin (PCT) in guiding pediatric systemic inflammatory response syndrome (SIRS) antibacterial drug therapy.

Methods

From April 2012 to March 2014, a total of 100 children with SIRS who hospitalized in Baoan District of Shenzhen Shajing People's Hospital Affiliated to Guangzhou Medical College were studied. After admission and detection of plasma PCT, they were randomly divided into PCT treatment group (n=50) and conventional treatment group (n= 50) by admission odd and even numbers. They all were given positive symptomatic and supportive treatment. Conventional treatment group developed antibacterial drug therapy program in accordance with the "Guidelines for Clinical Use of Antibacterial Drugs", PCT treatment group developed antibacterial drug therapy program in accordance with the values of plasma PCT dynamic monitoring results. Expenses and duration of hospitalization, expenses and duration of taking antibacterial drugs and its clinical curative effects, the incidence of complications and mortality were statistically analyzed between two groups. The study protocol was approved by the Ethical Review Board of Investigation in Baoan District of Shenzhen Shajing People's Hospital Affiliated to Guangzhou Medical College. Informed consent was obtained from the guardians of each participate. There had no significant differences of age and gender between two groups (P>0.05).

Results

The hospitalization expenses,duration and expenses of antibacterial drugs, rates of antibacterial drug usage and clinical efficiency indicators in PCT treatment group were significantly better than those in conventional treatment group, with significant difference (P<0.05). There had no significant differences between two groups among duration of hospitalization, incidence of septic shock, rates of multiple organ dysfunction syndrome (MODS) (P >0.05).

Conclusion

As a sensitive detection index of inflammatory reaction, the value of plasma PCT can be used as guidance of antibacterial drug therapy in children with SIRS.

Key words: Procalcitonin, Systemic inflammatory response syndrome, Antibacterial drug therapy

表1 两组住院时间、住院费用、抗菌药物使用时间及费用等指标的评估比较(±s)

Table 1 Comparison of duration and expenses of hospitalization, expenses and duration of taking antibacterial drugs between two groups (±s)

组别	n	住院时间(d)	抗菌药物使用时间(d)	住院费用(元）	抗菌药物费用(元）
PCT指导治疗组	50	7.1±1.2	6.7±0.8	3 078.6±170.2	347. 8±10.2
常规治疗组	50	9.7±1.9	9.6±0.9	4 077.9±179.3	479.2±12.1
t		1.576	6.825	17.971	23.558
P		>0.05	<0.05	<0.05	<0.05

表1 两组住院时间、住院费用、抗菌药物使用时间及费用等指标的评估比较(±s)

Table 1 Comparison of duration and expenses of hospitalization, expenses and duration of taking antibacterial drugs between two groups (±s)

组别	n	住院时间(d)	抗菌药物使用时间(d)	住院费用(元）	抗菌药物费用(元）
PCT指导治疗组	50	7.1±1.2	6.7±0.8	3 078.6±170.2	347. 8±10.2
常规治疗组	50	9.7±1.9	9.6±0.9	4 077.9±179.3	479.2±12.1
t		1.576	6.825	17.971	23.558
P		>0.05	<0.05	<0.05	<0.05

表2 两组患儿临床有效率、抗菌药物使用率、治疗后MODS发生率及死亡率等评估结果比较[n(%)]

Table 2 Comparison of clinical effective rates,usage rates of antibacterial drugs, incidence rates of MODS and motality after treatment between two groups[n(%)]

组别	n	临床有效率	抗菌药物使用率	MODS与感染性休克发生率	死亡率
PCT指导治疗组	50	48(96.0)	32(64.0)	3(6.0)	0(0.0)
常规治疗组	50	43(86.0)	45(90.0)	5(10.0)	0(0.0)
χ²		4.064	6.922	0.873	-
P		<0.05	<0.05	>0.05	-

表2 两组患儿临床有效率、抗菌药物使用率、治疗后MODS发生率及死亡率等评估结果比较[n(%)]

Table 2 Comparison of clinical effective rates,usage rates of antibacterial drugs, incidence rates of MODS and motality after treatment between two groups[n(%)]

组别	n	临床有效率	抗菌药物使用率	MODS与感染性休克发生率	死亡率
PCT指导治疗组	50	48(96.0)	32(64.0)	3(6.0)	0(0.0)
常规治疗组	50	43(86.0)	45(90.0)	5(10.0)	0(0.0)
χ²		4.064	6.922	0.873	-
P		<0.05	<0.05	>0.05	-

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