降钙素原、C-反应蛋白和白细胞计数在儿童感染性腹泻鉴别诊断中的意义  

Significance of procalcitonin,C-reactive protein and white blood cell counts in differential diagnosis of infectious diarrhea in children

作　　者：周莲莲[1] 陶洪群[1] 郭晶晶[1] 闫相楠 王玲莉[1] ZHOU Lian-lian;TAO Hong-qun;GUO Jing-jing;YAN Xiang-nan;WANG Ling-li(Department of Laboratory Medicine,Second Afiliated Hospital of Werzhou Medical College,Wenzhou,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院检验医学学科,浙江温州325027 [2]西北妇女儿童医院检验科,陕西西安710000

出　　处：《中国卫生检验杂志》2021年第8期959-961,967,共4页Chinese Journal of Health Laboratory Technology

基　　金：温州市科技局基础性科研项目(Y20180797)。

摘　　要：目的探讨降钙素原(PCT)、C-反应蛋白(CRP)和白细胞(WBC)等炎性指标在儿童感染性腹泻鉴别诊断中的意义。方法选取2016年1月-2019年12月温州医科大学附属第二医院收治的儿童病毒性肠道感染患者51例,细菌性肠道感染患者129例。比较所有患者新入院时的PCT、CRP及WBC结果,并分析这些指标在病毒和细菌感染患者之间的差异,对各项指标通过受试者工作特征曲线(ROC曲线)分析对病毒性和细菌性肠道感染鉴别诊断价值。结果细菌性肠道感染组WBC、CRP与PCT水平均明显高于病毒性感染组,差异有统计学意义(P均<0.05)。细菌性感染组WBC和CRP阳性率均显著高于病毒性感染组,差异有统计学意义(P均<0.05),而2组PCT阳性率差异无统计学意义(P>0.05)。细菌感染组PCT和CRP联合检测阳性率为52.71%,病毒感染组单独PCT指标阳性率为45.10%。ROC曲线中PCT、CRP、WBC的曲线下面积(AUC)分别为0.627、0.779、0.603,差异具有统计学意义(P<0.05)。结论 PCT、CRP和WBC检测在病毒性和细菌性肠道感染鉴别中有辅助诊断价值,PCT对CRP、WBC阴性的病毒性肠道感染具有提示作用,CRP对细菌性肠道感染的诊断价值高于PCT及WBC。Objective To explore the significance of procalcitonin(PCT),C-reactive protein(CRP)and white blood cell(WBC)in the differential diagnosis of intestinal infection in children.Methods A total of 51 children with viral intestinal infection and 129 children with bacterial intestinal infection were selected from January 2016 to December 2018 in the Second Affiliated Hospital of Wenzhou Medical University.The results of PCT,CRP and WBC of all patients at admission were compared,and the differences between viral and bacterial infections were analyzed.The diagnostic value of these indices for viral and bacterial intestinal infections was analyzed by ROC curve.Results The levels of WBC,CRP and PCT in bacterial intestinal infection group were significantly higher than those in viral infection group(P<0.05).The positive rate of WBC,CRP in bacterial infection group was significantly higher than that in viral infection group(P<0.05),but there was no statistical significance on the difference of PCT in two groups(P>0.05).The positive rate of PCT combined with CRP positive was52.71%in bacterial infection group,the rate of sole PCT in viral infection group was 45.10%.The area under curve(AUC)of PCT,CRP and WBC in ROC curve was 0.627,0.779,and 0.603,respectively,with the differences statistically significant(P<0.05).Conclusion The combined detection of PCT,CRP and WBC has auxiliary diagnostic value in the differential diagnosis of viral and bacterial intestinal infections.PCT has a suggestive effect on CRP and WBC negative viral intestinal infections,and CRP is more valuable in the diagnosis of bacterial intestinal infections than PCT and WBC.

关 键 词：降钙素原 C反应蛋白 白细胞计数 肠道感染 

分 类 号：R739.41[医药卫生—肿瘤]