四种炎性指标对小儿细菌性肺炎的诊断价值  

The Single and Joint Diagnostic Value of the Four Inflammatory Response Indexes for Bacterial Pneumonia in Children

作　　者：谢连志[1] 练明建 林晖[1] 洪国粦[1] XIE Lianzhi;LIAN Mingjian;LIN Hui;HONG Guolin(Department ofClinical Laboratory,The First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China)

机构地区：[1]厦门大学附属第一医院检验科,福建厦门361003

出　　处：《中国卫生标准管理》2019年第6期90-92,共3页China Health Standard Management

摘　　要：目的探讨常用炎性反应指标降钙素原(PCT)、白介素6(IL-6)、C反应蛋白(CRP)、白细胞计数(WBC)对小儿细菌性肺炎患者的单独和联合诊断价值。方法选取129例小儿细菌性肺炎患者、129例体检小儿以及40例小儿病毒性肺炎患者,比较三组PCT、IL-6、CRP和WBC的水平,利用ROC分析四种指标对于小儿细菌性肺炎的单独和联合诊断价值。结果小儿细菌性肺炎组血清中PCT、IL-6、CRP和WBC的水平均高于对照组和病毒性肺炎组,差异有统计学意义(P <0.01)。四种炎性标志物对于小儿细菌性肺炎均具有诊断价值,单独检测PCT的曲线下面积(0.938)最大以及敏感性(93.8%)最高,CRP的特异性(88.4%)最高;四项联合检测的曲线下面积为0.956(95%CI:0.938～0.974)。结论四种炎性物质在小儿细菌肺部感染的均具有诊断价值,其中PCT与IL-6的诊断价值高于CRP和WBC。四项指标联合检测对于小儿细菌肺部感染的诊断效能最高。Objective To explore single and joint diagnostic value of PCT,IL-6,CRP and WBC for bacterial pulmonary infection in children.Methods 129 children with bacterial pneumonia,129 children from physical examination center and 40 children with viral pneumonia were included in the study.The lever of PCT,IL-6,CRP and WBC were compared in the three group.ROC analysis was used to evaluate the single and joint diagnostic value of the four inflammatory response indexes.Results The levels of PCT,IL-6,CRP and WBC in children with bacterial pneumonia were higher than those in the other two groups(P<0.01).Four inflammatory markers have diagnostic value for bacterial pneumonia in children.The area under curve(0.938)and sensitivity(93.8%)of PCT alone are the highest,and the specificity(88.4%)of CRP is the highest,the four inflammatory response indexes was 0.956(95%CI:0.938~0.974).Conclusion All of the four inflammatory response indexes have the diagnostic value for pediatric bacterial pneumonia.PCT and Il-6 show better diagnostic value than CRP and WBC.The diagnostic value of the combination of the four inflammatory response indexes is best.

关 键 词：降钙素原 白介素6 C反应蛋白 白细胞计数 小儿细菌性肺炎 诊断 

分 类 号：R446[医药卫生—诊断学]