承德地区原发性肾病综合征儿童临床特点及C反应蛋白水平分析  

CLINICAL ANALYSIS OF EPIDEMIOLOGICAL CHARACTERISTICS OF PRIMARY NEPHROTIC SYNDROME AND LEVEL OF C-REACTIVE PROTEIN IN CHILDREN IN THE AREA OF CHENGDE

作　　者：郑志方[1] 陈国利[2] 郭春艳[1] 郭健[1] 杨康梅[1] 孙鹏[1] 刘霞[1] 

机构地区：[1]承德医学院附属医院小儿内科,河北省承德市067000 [2]承德医学院附属医院外一科,河北省承德市067000

出　　处：《中国煤炭工业医学杂志》2017年第2期125-128,共4页Chinese Journal of Coal Industry Medicine

基　　金：承德市科技支撑计划项目(编号:20151029)

摘　　要：目的探讨承德地区原发性肾病综合征(PNS)儿童流行病学特点及C反应蛋白在PNS诊断中的临床价值。方法选择该院2012年1月—2015年12月住院的PNS患儿80例,分为二组:PNS合并细菌感染组(55例)和PNS合并非细菌感染组(25例);对80例患儿的年龄、性别分布、临床分型进行分析,并对二组患儿C反应蛋白(CRP)及血清降钙素原(PCT)水平阳性率进行检测比较。结果 80例PNS患儿男61例,女19例,男、女比例为3.21∶1;其发病年龄1.46~12.60岁,平均(5.38±2.61)岁,其中,发病年龄3~6岁患儿居多(46例),占57.5%。按临床分型,单纯型71例,占88.9%;肾炎型9例,占11.1%。PNS合并细菌感染组CRP、PCT均明显升高,高于非细菌感染组,差异有统计学意义(P<0.05)。PNS合并细菌感染组中CRP的敏感性为78.1%,特异性为92.0%,其阳性预测值和阴性预测值分别为95.5%、65.7%;PCT的敏感性为56.4%,特异性为80.0%,其阳性预测值和阴性预测值分别为86.1%、45.5%。另外,在PNS合并细菌感染组内对CRP、PCT两个炎性指标对诊断细菌感染的敏感性进行比较,差异有统计学意义(P<0.05)。结论 PNS患儿中男多于女,发病年龄以3~6岁居多。在PNS合并细菌感染时CRP、PCT均明显升高,其中,CRP的敏感性及特异性均高于PCT,对于本地区临床PNS合并细菌感染诊断时具有指导意义。Objective To study the epidemiological characteristics of primary nephrotic syndrome（PNS）in children and to explore the value of C-reactive protein（CRP）level in the diagnosis of PNS.Methods We selected 80 cases with PNS,who enrolled author＇s hospital from Jan2012 to Dec 2015;and they were divided into two groups：PNS with bacterial infection（55 cases）,PNS with non-bacterial infection（25 cases）.The age and sexuality distribution,the clinical parting were analyzed;and tested the level of CRP and procalcitonin（PCT）for all the patients,then compared the ratio of positive with every groups.Results Of totally 80 children investigated,boys were 61 cases,girls were 19 cases,the ratio was 3.21∶1.All the patients,ages were from1.46 to 12.60,and the average age was 5.38±2.61.About 46 cases,occupied57.5%,were from3 to 6 years old.In accordance with clinical parting,about 71 cases（88.9%）were the type of simplicity,and the other 9 cases（11.1%）were the type of nephritis.CRP and PCT levels in the group of PNS with bacterial infection had significantly elevated when compared with PNS with non-bacterial infection（P〈0.05）.In the group of PNS with bacterial infection,CRP test for bacterial infection sensitivity was 78.1%,the specificity was 92.0%,the positive predictive value and the negative predictive value were 95.5%and65.7%respectively;and the sensitivity of PCT in this group was 56.4%,the specificity was 80.0%,the positive predictive value and the negative predictive value were 86.1% and 45.5%respectively.In addition,CRP and PCT were both inflammatory index to the diagnosis of bacterial infection on the sensitivity making comparisons in group of PNS with bacterial infection,the difference had statistical significance（P〈0.05）.Conclusion In PNS patients,male children are more than female,and more of them are with 3-6 years old.When PNS with bacterial infection,CRP and PCT levels are higher,and the sensitivity and specificity of CRP are higher than PCT for the diagnosis of PNS with bac

关 键 词：原发性肾病综合征 儿童 临床特点 C反应蛋白 降钙素原 

分 类 号：R725.9[医药卫生—儿科]