中性粒细胞、hs-CRP和PCT联合检测在小儿脓毒症诊断中的应用  

Application of neutrophil CD64,hs-CRP and PCT combined detection in diagnosis of pediatric sepsis

作　　者：丁小兰[1] 刘春霞[1] 贾建美[1] 崔蕾[2] DING Xiaolan;LIU Chunxia;JIA Jianmei;CUI Lei(Department of Clinical Laboratory,Nantong Ruici Hospital,Jiangsu Nantong 226010,China;Department of Pediatrics,Hai′an County People′s Hospital,Jiangsu nantong 226600,China)

机构地区：[1]南通瑞慈医院检验科,江苏南通226010 [2]南通市海安县人民医院儿科,江苏南通226600

出　　处：《新疆医科大学学报》2018年第7期829-833,共5页Journal of Xinjiang Medical University

基　　金：南通市科技计划项目(HS149111)

摘　　要：目的探讨中性粒细胞CD64、hs-CRP和PCT联合检测在小儿脓毒症诊断中的应用价值。方法选取2014年1月-2016年1月我院收治的脓毒症患儿45例作为观察组,同时选取同期非脓毒症患儿45例作为对照组,对2组中性粒细胞CD64的表达水平、hs-CRP水平、PCT水平及其诊断脓毒症阳性率检测进行比较,并对3项指标联合检测及单独检测的特异性、敏感性、阳性预测值和阴性预测值进行分析。结果观察组与对照组患者血小板减少差异无统计学意义(P>0.05),观察组患者血乳酸浓度及发热时间显著大于对照组患者(P<0.05)。观察组患者体内中性粒细胞CD64、hs-CRP、PCT及WBC水平显著高于对照组患者(P<0.05)。观察组患者中性粒细胞CD64、hs-CRP及PCT水平检测小儿脓毒症阳性率显著高于对照组(P<0.05)。90例患者中性粒细胞CD64、hs-CRP、PCT3种指标联合检测小儿脓毒症的敏感性、特异性、准确性、阳性预测值及阴性预测值显著高于CD64、hs-CRP、PCT单独检测(P<0.05)。结论中性粒细胞CD64、hs-CRP、PCT联合检测在小儿脓毒症的诊断中具有较高的应用价值,且3项指标联合检测更有利于患儿早期诊断率的提高,能够为小儿脓毒症的诊断及疗效评估提供有效依据。Objective To evaluate the value of neutrophil CD64,hypersensitive C-reactive protein（hs-CRP）and procalcitonin（PCT）combined detection in the diagnosis of pediatric sepsis.Methods Forty-five children with sepsis treated in our hospital from January 2014 to January 2016 were selected as the observation group,while 45 children with non-sepsis were selected as the control group.The detection of neutrophil CD64 expression levels,hs-CRP levels,and PCT levels in the diagnosis of sepsis were compared,and the specificity,sensitivity,positive predictive value and negative predictive value of the combined detection of the three indexes and the individual tests were compared and analyzed.Results The number of thrombocytopenia patients in the observation group was no significant difference with that of the control group（P〈0.05）.The blood lactic acid concentration and fever time in the observation group were significantly greater than those in the control group（P〈0.05）.The duration of diarrhea was significantly higher than that of the control group（P〈0.05）.The levels of neutrophil CD64 expression,serum hs-CRP,PCT level and positive rate in the observation group were significantly higher than those in the control group（P〈0.05）.The specificity and positive predictive value of the three indexes were significantly higher than those of CD64,hs-CRP and PCT,and the difference was statistically significant（P〈0.05）.Conclusion Neutrophil CD64,hs-CRP,PCT combined detection in the early diagnosis of pediatric sepsis has a high clinical value.Three indicators of combined detection is more conducive to the improvement of early diagnosis of children,which can provide effective basis for diagnosis and efficacy evaluation of pediatric sepsis.

关 键 词：小儿脓毒症 超敏C反应蛋白 降钙素原 中性粒细胞 

分 类 号：R459.7[医药卫生—急诊医学]