联合检测WBC、SAA、PCT、CRP在婴幼儿感染性疾病中的诊断价值  

Combined detection value of WBC,SAA,PCT and CRP in infant infection

作　　者：张永寿 王雁 何丽萍 王涛 ZHANG Yong-shou;WANG Yan;HE Li-ping;WANG Tao(Zhangye People′s Hospital Affiliated to Hexi University,Zhangye,Gansu 734000,China)

机构地区：[1]河西学院附属张掖人民医院,甘肃张掖734000

出　　处：《热带医学杂志》2020年第2期229-232,F0004,共5页Journal of Tropical Medicine

摘　　要：目的探讨白细胞计数(WBC)、血清淀粉样蛋白A(SAA)、降钙素原(PCT)、C反应蛋白(CRP)在婴幼儿感染性疾病中的诊断价值。方法 2018年2月至2018年6月在河西学院附属张掖人民医院儿科就诊的发热婴幼儿188例,选取经实验室检查证实的细菌感染组患儿48例与病毒感染组患儿56例为研究对象,另外选取同期体检健康的婴幼儿50例作为健康对照组。检测上述患儿及体检健康婴幼儿WBC、SAA、PCT和CRP水平,比较三组间指标的差异,采用受试者工作特征(ROC)曲线分析上述指标在婴幼儿细菌和病毒感染性疾病中的诊断效能。结果细菌感染组患儿PCT、CRP、WBC明显高于健康对照组和病毒感染组,差异有统计学意义(P<0.05),SAA水平高于健康对照组,差异有统计学意义(P<0.05),与病毒感染组差异无统计学意义(P>0.05);病毒感染组患儿SAA、WBC、PCT、CRP高于健康对照组,差异有统计学意义(P<0.05)。WBC、SAA、PCT与CRP联合诊断细菌感染性疾病ROC曲线下面积(AUC)为0.891,其灵敏度为87.50%,特异度为93.40%,准确度为91.56%,均高于单一指标;SAA与CRP联合诊断病毒感染性疾病AUC为0.821,其灵敏度为89.29%,特异度为91.83%,准确度为90.91%,均高于单一指标。结论 WBC、SAA、PCT与CRP联合诊断婴幼儿细菌和病毒感染性疾病价值较高,有助于婴幼儿感染性疾病早期快速诊断和鉴别。Objective To explore the diagnostic values of white blood cell count(WBC),serum amyloid A(SAA),procalcitonin(PCT)and C-reactive protein(CRP)in infectious diseases of infants and young children. Methods 188 infants with fever in our pediatric department from February 2018 to June 2018 were selected as the research objects. 48 infants with bacterial infection and 56 infants with viral infection were confirmed by laboratory examination. Another 50 infants with healthy physical examination during the same period were selected as the healthy control group. The levels of WBC,SAA,PCT and CRP in the above-mentioned children and healthy infants were detected,and the differences among the three groups were compared. The diagnostic efficacy of the above-mentioned indicators in bacterial and viral infectious diseases of infants was analyzed by ROC curve. Results PCT,CRP,WBC in bacterial infection group were significantly higher than those in healthy control group and virus infection group(P<0.05). SAA level in infection group was higher than that in healthy control group(P<0.05),and there was no significant difference between bacterial infection group and virus infection group(P>0.05). SAA,WBC,PCT and CRP in virus infection group were higher than those in healthy control group(P<0.05). The area under ROC curve(AUC)of WBC,SAA,PCT and CRP in the diagnosis of bacterial infectious diseases was 0.891,and the sensitivity,specificity and accuracy were 87.50%,93.40% and 91.56%,respectively. The AUC of SAA and CRP in the diagnosis of viral infectious diseases was 0.821,and the sensitivity and specificity and accuracy were 89.29%,91.83% and 90.91% respectively,and the accuracy was higher than that of single index.Conclusion WBC,SAA,PCT and CRP were of high value in the diagnosis of bacterial and viral infectious diseases in infants and young children,which was helpful to the early and rapid diagnosis and differentiation of infectious diseases in infants and young children.

关 键 词：婴幼儿感染 白细胞计数 血清淀粉样蛋白A 降钙素原 C反应蛋白 

分 类 号：R725.6[医药卫生—儿科]