降钙素原、白介素-6、C反应蛋白和白细胞在感染性腹泻鉴别诊断中的应用价值  

Value of procalcitonin,interleukin-6,C reative protein and white blood cell levels in diagnosis and treatment of diarrhea in children

作　　者：付水[1] 庄国华[1] 李宏[1] 张超飞[2] 祁志荣 褚邦勇[2] 

机构地区：[1]杭州市余杭区第一人民医院,浙江余杭311000 [2]浙江省台州医院,浙江台州317000 [3]煤炭总医院,北京100028

出　　处：《疾病监测》2014年第5期359-363,共5页Disease Surveillance

摘　　要：目的探讨降钙素原(procalcitonin,PCT)、白介素-6(interleukin-6,IL-6)、C反应蛋白(C reative protein,CRP)和白细胞(white blood cell,WBC)在儿童腹泻过程中的诊断价值。方法收集85例腹泻患儿和35例健康体检儿童的标本,根据检测结果和病史分为轮状病毒组(48例)、细菌感染组(37例)和正常对照组(35例),在入院第4天再次对轮状病毒组进行粪便培养,根据结果分为无继发细菌感染组和继发细菌感染组。检测轮状病毒抗原、PCT、IL-6、CRP和WBC水平。结果轮状病毒组的PCT、IL-6、CRP和WBC均低于细菌感染组,但高于正常对照组且差异均有统计学意义(P<0.05);PCT、IL-6、CRP和WBC均具有较强的诊断效力,PCT和IL-6的阳性预测值、阴性预测值、特异性、敏感度略优于CRP和WBC;轮状病毒组的并发细菌感染患儿在入院第4天和第7天的PCT、IL-6、CRP和WBC也均显著高于无并发细菌感染患儿。结论血清中PCT、IL-6、CRP和WBC检测在轮状病毒性儿童腹泻的鉴别诊断具有较高的效力,可以作为轮状病毒性腹泻患儿早期诊断、疗效评估和并发症预测指标。Objective To evaluate the value of of procalcitonin （ PCT）, intedeukin-6 （ IL-6 ）, Creative protein （CRP） and white blood cell （WBC） levels in the diagnosis and treatment of diarrhea in children. Methods Stool samples were collected from 85 children with diarrhea （48 from children infected with rotavirus, 37 from children with bacterial infection） and 35 healthy children to detect rotavirus antigen, PCT, IL-6, CRP and WBC. Four days after hospitalization, stool samples were collected again from children infected with rotavirus, and rotavirus antigen, PCT, IL-6, CRP and WBC were detected in children with or without secondary infections. Results The PCT, IL-6, CRP and WBC levels in rotavirus group were lower than those in bacterial infection group, but higher than those in control group, the differences were statistical significance （P 〈 0.05 ）. The detections of PCT, IL-6, CRP and WBC have great value in the diagnosis and treatment of diarrhea in children, but the positive predicting values, negative predicting values, specificities and sensitivities of PCT and IL-6 were higher than those of CRP and WBC. The levels of PCT, IL-6, CRP and WBC in rotavirus group with secondary bacterial infection were significantly higher than those in rotavirus group without secondary bacterial infections. Conclusion PCT, IL-6, CRP and WBC levels can be used as markers in the early diagnosis of rotavirus infection in children and in related diagnosis evaluation and complication prediction.

关 键 词：轮状病毒 降钙素原 白介素-6 超敏C反应蛋白 白细胞 

分 类 号：R725.1[医药卫生—儿科]