血清降钙素原在门诊儿童感染性疾病诊断中的价值  

Value of serum procalcitonin in diagnosis of infectious diseases in children at an outpatient department

作　　者：任瑞平[1,2] 

机构地区：[1]湖北医药学院附属襄阳医院 [2]襄阳市第一人民医院,湖北襄阳441000

出　　处：《中国感染控制杂志》2013年第5期363-366,共4页Chinese Journal of Infection Control

摘　　要：目的探讨血清降钙素原(PCT)检测在门诊就诊儿童感染性疾病诊断中的应用价值。方法采用半定量固相免疫法测定某院儿科门诊166例发热患儿(分为细菌感染组98例,非细菌感染组68例)及同期60例健康体检儿童(对照组)血清PCT水平,同时检测血常规及C-反应蛋白(CRP),对3组结果进行比较。结果细菌感染组PCT、CRP、白细胞(WBC)计数、中性粒细胞百分比阳性率分别为92.86%(98例)、88.78%(87例)、86.73%(85例)、81.63%(80例),显著高于非细菌感染组[分别为10.29%(7例)、27.94%(19例)、25.00%(17例)、26.47%(18例)]和对照组[分别为6.67%(4例)、5.00%(3例)、8.33%(5例)、11.67%(7例)],差异均有统计学意义(P<0.01)。细菌感染组血清PCT检测的敏感性(92.86%)、特异性(89.71%)、约登指数(82.56)均高于CRP(分别为88.78%、72.06%、60.84)、WBC计数(分别为86.73%、75.00%、42.30)、中性粒细胞百分比(分别为81.63%、73.53%、55.15)。结论 PCT可以作为儿童门诊快速诊断早期细菌感染的一个指标,且相比其他炎症指标具有更好的敏感性与特异性。Objective To evaluate the value of serum procalcitonin（PCT）in diagnosis of infectious diseases in children at an outpatient department.Methods Serum PCT value of 166 children with fever（98in bacterial infection group,68in non-bacterial infection group）and 60 healthy children（control group）were detected by semi-quantitative solid phase immunoassay,and blood routine test and C-reactive protein（CRP）were also detected simultaneously,results of three groups were compared.Results In bacterial infection group,the positive rates of PCT,CRP,white blood cell（WBC）count,and percentage of neutrophils were 92.86%（98 cases）,88.78%（87 cases）,86.73%（85 cases）,and 81.63%（80 cases）respectively,which were significantly higher than those of non-bacterial infection group（10.29%[7 cases],27.94%[19 cases],25.00%[17 cases],26.47%[18 cases]）and control group（6.67%[4cases],5.00%[3 cases],8.33%[5cases],11.67%[7cases]）respectively（P0.01）.Sensitivity（92.86%）,specificity（89.71%）and Youden＇s index（82.56）of serum PCT detection of bacterial infection group were all higher than those of CRP（88.78%,72.06%,60.84 respectively）and WBC（86.73%,75.00% and 42.30 respectively）and percentage of neutrophil（81.63%,73.53%and55.15 respectively）.Conclusion PCT can be used as an indicator of the rapid diagnosis of early bacterial infection in children,and is with better sensitivity and specificity than the other inflammatory markers.

关 键 词：降钙素原 感染性疾病 儿童 诊断 敏感性 特异性 

分 类 号：R446.1[医药卫生—诊断学]