降鈣素原為住院發燒嬰兒及幼童之細菌感染的指標

Procalcitonin as a Marker for Bacterial Infection in Febrile Infants and Young Children

在區域醫院兒科工作所碰到的病患大多屬於一般兒科(General Pediatrics)的範疇，其中以發燒而轉診至門急診的病患為大宗。快速的鑑別其是否為危險的細菌性感染是有其必要的，而這也是轉診醫師，家長及臨床醫師亟欲所知的。在急性反應物質(acute phase reactant)的檢測上，由近來的研究我們知道降鈣素原(procalcitonin)在1.住進加護病房敗血症病患的預測其預後；2.疑似敗血症病患初到急診時的追蹤預後，這兩方面有其價值。本研究簡短的在此拋磚引玉探討是否在一般兒科病房收治的發燒幼童其procalcitonin值跟其臨床疾病尤其是細菌感染的疾病是否有相關性，並且跟傳統臨床上常測的C-reactive protein和白血球計數值做比較。

Early detection of bacterial infections in infants and young children is important. An appropriate acute phase reactant to differentiate between fever from a bacterial source and fever from a non-bacterial source is essential to pediatricians in inpatient, outpatient, and emergency departments. We compared the white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT) values in febrile infants and young children who were admitted to a pediatric ward in a regional teaching hospital. PCT showed a significant difference between the bacterial and non-bacterial infection groups (P=0.002). WBC and CRP showed no significant differences between groups. PCT with a cutoff value of 0.4 ng/mL could be an important tool for detecting bacterial infections in febrile infants and young children.