血清降钙素原、C-反应蛋白和白细胞计数在儿童呼吸道感染诊断中的价值  

Detection value of serum procalcitonin, C-reactive protein and WBC in children with respiratory tract infection

作　　者：傅娟 周燕 孙爱华[2] EU Juan;ZHOU Yan;SUN Ai-hua(Clinical Laboratory, People's Hospital of Yuecheng District, Shaoxing, Zhejiang 312000, China)

机构地区：[1]绍兴市越城区人民医院检验科,浙江绍兴312000 [2]杭州医学院,浙江杭州310053

出　　处：《中国卫生检验杂志》2019年第11期1340-1341,1344,共3页Chinese Journal of Health Laboratory Technology

基　　金：浙江省卫生高层次创新人才培养计划资助(2012[241]])

摘　　要：目的探讨血清降钙素原(PCT)、C-反应蛋白(CRP)和白细胞(WBC)计数在儿童呼吸道感染临床诊断中的价值。方法回顾性分析355例呼吸道感染患儿,根据病原体检测的结果,分为细菌感染组(122例)、肺炎支原体感染组(112例)和病毒感染组(121例),所有患儿采集静脉血进行WBC计数、分离血清并检测PCT和CRP水平。结果细菌组血清PCT、CRP和WBC水平明显高于其他2组(P<0.05)。以0.5μg/ml、8 mg/L和10.0×10~9/L分别为血清PCT、CRP和WBC异常的界值,血清PCT诊断呼吸道细菌性感染的灵敏度明显高于WBC(P<0.05),血清PCT诊断呼吸道细菌性感染的特异度、阳性预测值、阴性预测值和准确度均明显高于血清CRP和WBC(P<0.05)。血清PCT、CRP和WBC诊断呼吸道细菌性感染的约登指数分别为0.81、0.47和0.46。结论血清PCT、CRP及WBC检测对鉴别儿童细菌性和非细菌性呼吸道感染有一定的指导价值,PCT在诊断呼吸道细菌感染时有着更好的灵敏度、特异度及准确率。Objective To explore the detection value of serum procalcitonin(PCT), C-reactive protein(CRP) and WBC level in children with respiratory tract infection. Methods A total of 355 children patients with respiratory tract infection were conducted for retrospectively analyzed and grouped, including 122 cases with bacterial infection(bacterial group), 112 cases with mycoplasma pneumoniae infection(mycoplasma pneumoniae group) and 121 cases with virus infection(virus group). Venous blood from all children was collected for WBC counting, serum separation and detection of PCT and CRP levels. Results The levels of PCT, CRP and WBC in bacteria group were significantly higher than the other two groups(P<0.05). With the levels of PCT≥0.5 μg/ml, CRP≥8 mg/L and WBC≥10.0×10^9/L as positive standard. The sensitivity of PCT was significantly higher than that of WBC(P<0.05). The PCT specificity, positive predictive value, negative predictive value and accuracy were significantly higher than CRP and WBC(P<0.05). Youdens index of PCT, CRP and WBC were 0.81, 0.47 and 0.46, respectively. Conclusion Serum PCT, CRP and WBC tests have certain guiding value for the identification of bacterial and non-bacterial respiratory infections in children. PCT has better sensitivity, specificity and accuracy in the diagnosis of respiratory bacterial infections.

关 键 词：降钙素原 C-反应蛋白 白细胞计数 儿童 呼吸道感染 

分 类 号：R725.6[医药卫生—儿科]