降钙素原与C-反应蛋白联合评分系统诊断儿童侵袭性细菌性腹泻  

Combination of procalcitonin and C-reactive protein for the diagnosis of invasive bacterial diarrhea in children

作　　者：吴蔚[1] 万宏[1] 段亚群 周艳[2] 许增华[1] 张双红[1] 肖珍君 万盛华[1] WU Wei;WAN Hong;DUAN Yaqun;ZHOU Yan;XU Zenghua;ZHANG Shuanghong;XIAO Zhenjun;WAN Shenghua(Department of Digestion,Children's Hospital of Jiangxi Province, Nanchang 330006, Jiangxi, China;Department of Clinical Laboratory, Children's Hospital of Jiangxi Province, Nanchang 330006, Jiangxi, China)

机构地区：[1]江西省儿童医院消化科,江西南昌330006 [2]江西省儿童医院检验科,江西南昌330006

出　　处：《临床儿科杂志》2017年第10期721-724,共4页Journal of Clinical Pediatrics

基　　金：江西省卫生计生委科技计划课题(No.20165502)

摘　　要：目的构建血降钙素原与C-反应蛋白联合评分系统以诊断儿童侵袭性细菌性腹泻。方法回顾性收集住院的急性腹泻病患儿的临床资料,将患儿分为侵袭性细菌性腹泻组与非细菌性腹泻组。以血降钙素原与C-反应蛋白为参数,通过二分类logistic回归分析构建诊断儿童侵袭性细菌性腹泻的联合评分系统,利用受试者工作特征(ROC)曲线评价其诊断准确性。结果共纳入侵袭性细菌性腹泻患儿110例与非细菌性腹泻患儿108例。侵袭性细菌性腹泻组的血降钙素原与C-反应蛋白水平明显高于非细菌性腹泻组,差异有统计学意义(P均<0.05)。构建的联合评分系统诊断侵袭性细菌性腹泻的ROC曲线下面积(AUC)为0.894,大于血降钙素原或C-反应蛋白(P<0.05);联合评分的最佳诊断界值为0.52,其灵敏度为80.9%,特异度为88.9%。结论血降钙素原与C-反应蛋白联合评分系统对儿童侵袭性细菌性腹泻诊断准确性良好,可协助临床早期准确诊断。Objective To construct a scoring system of combination of procalcitonin and C-reactive protein for diagnosis of invasive bacterial diarrhea in children.Methods The clinical data of hospitalized children with acute diarrhea were retrospectively analyzed.All of the children were divided into two groups,invasive bacterial diarrhea group and nonbacterial diarrhea group.The scoring system of combination of two markers for diagnosis of invasive bacterial diarrhea in children was constructed by means of two categories logistic regression analysis using procalcitonin and C-reactive protein as parameters.In addition,receiver operating characteristic curve(ROC)was used to evaluate the diagnostic accuracy.Results One hundred ten cases of invasive bacterial diarrhea and108cases of nonbacterial diarrhea were included.The levels of serum procalcitonin and Creactive protein in invasive bacterial diarrhea group were significantly higher than those in nonbacterial diarrhea group,and there were statistical difference(P all<0.05).The area under the ROC curve(AUC)of invasive bacterial diarrhea was0.894when the established scoring system was used,which was higher than the AUCs when either serum procalcitonin or in C-reactive protein was used(P<0.05).The best diagnostic boundary value for combination of serum procalcitonin and C-reactive protein scoring was0.52with a sensitivity at80.9%and specificity at88.9%.Conclusions The scoring system of combination of procalcitonin and C-reactive protein has good accuracy in diagnosis of invasive bacterial diarrhea in children,and can assist the early diagnosis of the disease.

关 键 词：降钙素原 C-反应蛋白 细菌性腹泻 儿童 

分 类 号：R725.7[医药卫生—儿科]