PCT与CRP和WBC及前白蛋白联合检测对儿科感染性疾病早期诊断的价值
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摘要
目的探讨联合检测降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)以及前白蛋白在小儿感染性疾病早期诊断中的临床价值。方法选取医院儿科2015年12月-2016年6月收治的疑似感染性疾病患儿226例为研究对象,根据是否确诊为感染性疾病分为感染组156例和非感染组70例,感染组患儿根据感染病原体类型分为细菌感染组88例和非细菌感染组68例,检测所有患儿血PCT、CRP、WBC及前白蛋白水平,并分别分析PCT、CRP、WBC及前白蛋白单独检测与联合检测对儿科感染性疾病的早期诊断效能。结果感染组患儿PCT、CRP以及WBC水平均高于非感染组(P<0.05),前白蛋白水平则低于非感染组(P<0.05);细菌感染组患儿PCT、CRP以及WBC水平均高于非细菌感染组,前白蛋白水平则低于非细菌感染组(P<0.05);联合检测对儿科感染性疾病早期诊断灵敏度及阴性预测值分别为95.5%、89.6%,高于各指标单独检测(P<0.05)。结论 PCT、CRP、WBC以及前白蛋白联合检测能够有效提高儿科感染性疾病的早期诊断灵敏度,同时对于病情评估、疗效评价和预后判断等方面均具有重要的临床意义。
OBJECTIVE To explore the clinical value of joint detection of procalcitonin(PCT),C-reactive protein(CRP),white blood cell(WBC)counts and prealbumin in early diagnosis of children with infectious diseases.METHODS A total of 226 children with suspected infectious diseases who were treated in the hospital from Dec2015 to Jun 2016 were recruited as the study objects and divided into the infection group with 156 cases and the non-infection group with 70 cases according to the diagnosis of infectious diseases,the children in the infection group were divided into the bacterial infection group with 88 cases and the non-bacterial infection group with 68 cases according to the pathogens causing the infection.The levels of serum PCT,CRP,WBC and prealbumin of all the children were detected.The efficacies of the single PCT,CRP,WBC and prealbumin and the joint detection of the above indexes in early diagnosis of the children with infectious diseases were observed.RESULTS The levels of PCT,CRP and WBC of the infection group were significantly higher than those of the non-infection group(P<0.05),the prealbumin level of the infection group was significantly lower than that of the non-infection group(P<0.05).The levels of PCT,CRP and WBC of the bacterial infection group were higher than those of the non-bacterial infection group,while the prealbumin level of the bacterial infection group was significantly lower than that of the non-bacterial infection group(P<0.05).The sensitivity and negative predictive value of the joint detection were respectively 95.5% and 89.6%in the early diagnosis of the children with infectious diseases,significantly higher than those of the single detection(P<0.05).CONCLUSION The joint detection of PCT,CRP,WBC and prealbumin may effectively raise the sensitivity in early diagnosis of the children with infectious diseases,and it has great clinical significance in evaluation of illness condition and curative effect as well as prediction of prognosis.
OBJECTIVE To explore the clinical value of joint detection of procalcitonin(PCT),C-reactive protein(CRP),white blood cell(WBC)counts and prealbumin in early diagnosis of children with infectious diseases.METHODS A total of 226 children with suspected infectious diseases who were treated in the hospital from Dec2015 to Jun 2016 were recruited as the study objects and divided into the infection group with 156 cases and the non-infection group with 70 cases according to the diagnosis of infectious diseases,the children in the infection group were divided into the bacterial infection group with 88 cases and the non-bacterial infection group with 68 cases according to the pathogens causing the infection.The levels of serum PCT,CRP,WBC and prealbumin of all the children were detected.The efficacies of the single PCT,CRP,WBC and prealbumin and the joint detection of the above indexes in early diagnosis of the children with infectious diseases were observed.RESULTS The levels of PCT,CRP and WBC of the infection group were significantly higher than those of the non-infection group(P<0.05),the prealbumin level of the infection group was significantly lower than that of the non-infection group(P<0.05).The levels of PCT,CRP and WBC of the bacterial infection group were higher than those of the non-bacterial infection group,while the prealbumin level of the bacterial infection group was significantly lower than that of the non-bacterial infection group(P<0.05).The sensitivity and negative predictive value of the joint detection were respectively 95.5% and 89.6%in the early diagnosis of the children with infectious diseases,significantly higher than those of the single detection(P<0.05).CONCLUSION The joint detection of PCT,CRP,WBC and prealbumin may effectively raise the sensitivity in early diagnosis of the children with infectious diseases,and it has great clinical significance in evaluation of illness condition and curative effect as well as prediction of prognosis.
引文
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[11]红娟,高锦萍.WBC/hsCRP/PCT在新生儿感染性疾病早期诊断中的价值[J].西部医学,2015,13(11):1692-1694,1698.
[12] Kuo KC,Huang YH,Chen IL,et al.Are antibiotics beneficial to children suffering from enterovirus infection complicated with a high C-reactive protein level[J].Int J Infect Dis,2014,12(2):89-92.
[13]黄美琼,张广清,葛晶晶,等.感染性疾病患儿血清降钙素原、CRP及WBC的变化及临床意义[J].国际检验医学杂志,2015,9(12):213-214.
[14]孙霆芳,赵环宇.83例小儿急性下呼吸道感染的病原学检测及其分析[J].中国医学创新,2018,15(12):34-37.
[15] Martinez-Estevez NS,Alvarez-Guevara AN,Rodriguez-Martinez CE.Effects of zinc supplementation in the prevention of respiratory tract infections and diarrheal disease in Colombian children:a 12-month randomised controlled trial[J].Allergol Immunopathol(Madr),2016,44(4):368-375.
[16] Shi Y,Rui X.Procalcitonin kinetics:a reliable tool for diagnosis and monitoring of the course of bacterial infection in critically ill patients with autoimmune diseases[J].Intensive Care Med,2013,39(12):2233-2334.
[2]吕海涛,顾曜芳,贾飞,等.某医院儿科患者下呼吸道感染病原菌分布及耐药性分析[J].中国消毒学杂志,2018,35(3):196-198.
[3] Ma G,Zhu Y,Xiao Y,et al.Species C is predominant in Chinese children with acute respiratory adenovirus infection[J].Pediatr Infect Dis J,2015,34(9):1042.
[4] Venkatachalam V,Hendley JO,Willson DF.The diagnostic dilemma of ventilator-associated pneumonia in critically ill children[J].Pediatr Crit Care Med,2011,12(3):286-296.
[5]彭俊争,邓力,卢根.秋冬季小儿呼吸道感染的病原学检测及其分布特点分析[J].中国医药科学,2016,6(16):21-24.
[6] Lin KH,Wang FL,Wu MS,et al.Serum procalcitonin and C-reactive protein levels as markers of bacterial infection in patients with liver cirrhosis:a systematic review and meta-analysis[J].Diagn Microbiol Infect Dis,2014,80(1):72-78.
[7]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[8]黄文红,刘光华,林晟.小儿重症感染性疾病并发肝功能损害的回顾性研究[J].肝脏,2016,21(10):858-860.
[9] Blasi F,Stolz D,Piffer F.Biomarkers in lower respiratory tract infection[J].Pulm Pharmocol Ther,2010,23(6):501-507.
[10]刘长志,司佳亚,陈新胜.呼吸机相关性肺炎并发假丝酵母菌感染患者PCT、IL-6和CRP水平分析[J].中华医院感染学杂志,2017,27(14):3150-3153.
[11]红娟,高锦萍.WBC/hsCRP/PCT在新生儿感染性疾病早期诊断中的价值[J].西部医学,2015,13(11):1692-1694,1698.
[12] Kuo KC,Huang YH,Chen IL,et al.Are antibiotics beneficial to children suffering from enterovirus infection complicated with a high C-reactive protein level[J].Int J Infect Dis,2014,12(2):89-92.
[13]黄美琼,张广清,葛晶晶,等.感染性疾病患儿血清降钙素原、CRP及WBC的变化及临床意义[J].国际检验医学杂志,2015,9(12):213-214.
[14]孙霆芳,赵环宇.83例小儿急性下呼吸道感染的病原学检测及其分析[J].中国医学创新,2018,15(12):34-37.
[15] Martinez-Estevez NS,Alvarez-Guevara AN,Rodriguez-Martinez CE.Effects of zinc supplementation in the prevention of respiratory tract infections and diarrheal disease in Colombian children:a 12-month randomised controlled trial[J].Allergol Immunopathol(Madr),2016,44(4):368-375.
[16] Shi Y,Rui X.Procalcitonin kinetics:a reliable tool for diagnosis and monitoring of the course of bacterial infection in critically ill patients with autoimmune diseases[J].Intensive Care Med,2013,39(12):2233-2334.