摘要目的:通过对血清降钙素原（PCT）及超敏C-反应蛋白（hs-CRP）进行动态监测，以评估脓毒症患儿的临床治疗效果。方法:选取2015年1月至2019年4月安徽省太和县人民医院诊治的脓毒症住院患儿75例为脓毒症组，选择同期健康体检儿童75例为正常对照组。分别采用化学发光法及免疫比浊法检测两组的PCT和hs-CRP值，比较两组血清PCT、hs-CRP水平差异。脓毒症组治疗72 h后急性生理学及慢性健康状况Ⅱ评分（APACHEⅡ评分）<27分者为疗效较好组（50例），≥ 27分者为疗效欠佳组（25例），监测两组入院时、治疗24 h后、治疗72 h后的PCT、hs-CRP值及APACHEⅡ评分的变化。结果:脓毒症组患儿血清PCT、hs-CRP水平显著高于正常对照组[（5.37 ± 1.56）μg/L比（0.32 ± 0.10）μg/L、（64.6 ± 9.5）mg/L比（4.2 ± 1.2）mg/L]，差异有统计学意义（ P<0.01）。疗效较好组治疗后1、3、5 d的PCT、hs-CRP值及APACHEⅡ评分逐渐降低，而疗效欠佳组PCT、hs-CRP值及APACHEⅡ评分降低不明显甚至继续升高，两组各时间点PCT、hs-CRP值及APACHEⅡ评分比较差异均有统计学意义（ P<0.01）。Pearson相关性分析显示，入院时脓毒症患儿血清PCT与hs-CRP、APACHEⅡ评分之间存在正相关性（ r=0.846、0.531， P<0.05）。hs-CRP与APACHEⅡ评分之间也存在正相关性（ r=0.558， P<0.05）。PCT联合hs-CRP检测脓毒症的灵敏度和特异度为98.7%和93.5%。 结论:PCT联合hs-CRP检测有助于儿童脓毒症的早期诊断，并通过对PCT及hs-CRP值的动态监测，能对患儿的临床治疗效果进行评估。

abstractsObjective:To evaluate the clinical efficacy of sepsis in children by dynamic monitoring of serum procalcitonin (PCT) and hypersensitive C-reactive protein (hs-CRP).Methods:Seventy-five children with sepsis hospitalized in Taihe County People′s Hospital from January 2015 to April 2019 were selected as the sepsis group, and 75 healthy children in the same period were selected as the control group. The values of PCT and hs-CRP in two groups were detected by chemiluminescence and immunoturbidimetry respectively, and the levels of serum PCT and hs-CRP were compared between the two groups. According to the PCT, hs-CRP value and APACHE Ⅱ score at 72 h after treatment, children in sepsis group can be divided into two groups: good curative effect group (APACHE Ⅱ <27 scores)and poor curative effect group with (APACHE Ⅱ ≥27 scores).The changes of serum PCT, hs-CRP and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score in two group were monitored dynamically at different time points, and data were analyzed by SPSS 18.0 software.Results:The levels of PCT and hs-CRP in sepsis group were significantly higher than those in control group [(5.37 ± 1.56) μg/L vs. (0.32 ± 0.10) μg/L, (64.6 ± 9.5) mg/L vs. (4.2 ± 1.2) mg/L] ( P<0.01). At 1, 3 and 5 d after treatment, the levels of PCT, hs-CRP value and APACHE Ⅱ scores in good curative effect group were significantly reduced. However, the levels of PCT, hs-CRP and APACHE Ⅱ scores in poor curative effect group did not decrease significantly or even continued to increase, and the levels of PCT, hs-CRP and APACHE Ⅱ scores in good curative effect group at different time point were significantly higher than those in poor curative effect group ( P<0.01). In sepsis group, the level of PCT had positive correlation with hs-CRP and APACHE Ⅱ ( r=0.846, P<0.05; r=0.531, P<0.05), and the level of hs-CRP had positive correlation with APACHEⅡ( r=0.558, P<0.05). The sensitivity and specificity of PCT combined with hs-CRP in diagnosis of sepsis was 98.7% and 93.5%. Conclusions:PCT combined with hs-CRP detection is helpful for the early diagnosis of sepsis, and through the dynamic monitoring of PCT and hs-CRP values, the therapeutic efficacy of children can be evaluated.