手足口病合并细菌感染患儿血清降钙素原早期检测的临床意义  

Clinical significance of early detection of serum procalcitonin in children with hand-foot-and-mouth disease complicated by bacterial infection

作　　者：邱苗 金海华[2] Qiu Miao;Jin Haihua(Department of Infection,First People's Hospital of Taizhou,Taizhou 318020,Zhejiang Province,China;Department of Pediatrics,Taizhou Hospital,Linhai 317000,Zhejiang Province,China)

机构地区：[1]浙江省台州市第一人民医院感染科,318020 [2]浙江省台州医院儿科,317000

出　　处：《中国基层医药》2021年第7期1074-1078,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨手足口病合并细菌感染患儿血清降钙素原(PCT)早期检测的临床意义,为患儿的临床诊断提供参考。方法选取台州市第一人民医院2017年12月至2018年12月收治的手足口病患儿126例为研究对象,根据患儿的感染情况将患儿分为合并细菌感染组和单纯病毒感染组,每组63例。同时,选取同期在台州市第一人民医院体检中心体检健康儿童20例为对照组。两组均进行外周血白细胞介素6(IL-6)、白细胞介素10(IL-10)、外周白细胞计数(WBC)、C反应蛋白(CRP)、PCT水平的比较分析,并对患儿的致病菌感染情况进行分析。结果单纯病毒感染组患儿IL-6[(3.75±0.76)ng/L]、IL-10[(55.31±11.27)ng/L]、CRP[(10.91±1.16)mg/L]均明显高于对照组[(1.39±0.41)ng/L、(11.72±9.58)ng/L、(2.16±0.65)mg/L],均差异有统计学意义(t=8.040、16.982、7.825,均P<0.05);合并细菌感染组IL-6[(4.10±1.09)ng/L]、IL-10[(66.64±7.42)ng/L]均明显高于对照组和单纯病毒感染组,均差异有统计学意义(t=13.088、9.053、10.031、15.021,均P<0.05)。合并细菌感染组CRP(26.28±4.35)mg/L]高于单纯病毒感染组[(10.91±1.16)mg/L](t=21.938,P<0.05)。合并细菌感染组PCT[(0.63±0.04)μg/L]、WBC[(15.12±3.97)×10^(9)/L]均高于对照组[(0.13±0.02)μg/L、(7.93±1.91)×10^(9)/L]和单纯病毒感染组[(0.07±0.01)μg/L、(8.78±1.12)×10^(9)/L],均差异有统计学意义(均P<0.05)。单纯病毒感染患儿肠道病毒71型(EV71)、通用型肠道病毒(EV)的感染率均低于合并细菌感染患儿,均差异有统计学意义(χ^(2)=20.329、31.924,均P<0.05)。结论检测血清PCT水平对手足口病合并细菌感染有特异性高、准确性好的特点,与WBC检测可共同作为鉴别手足口病患儿是否存在细菌感染的敏感指标。Objective To investigate the clinical significance of early detection of serum procalcitonin in children with hand-foot-and-mouth disease complicated by bacterial infection and provide reference for clinical diagnosis of the disease in children.Methods A total of 126 children patients with hand-foot-and-mouth disease who received treatment in the First People's Hospital of Taizhou between December 2017 and December 2018 were included in this study.They were assigned into viral plus bacterial infection group and simple viral infection group(n=63/group)according to whether they suffered from bacterial infection.An additional 20 healthy children who concurrently received physical examination in the First People's Hospital of Taizhou were included in the control group.Serum levels of interleukin-6,interleukin-10,white blood cell count,C-reactive protein,and procalcitonin were compared among the three groups and bacterial infection was analyzed.Results Serum levels of interleukin-6,interleukin-10 and C-reactive protein in the simple viral infection group were(3.75±0.76)ng/L,(55.31±11.27)ng/L,(10.91±1.16)mg/L,respectively,which were significantly higher than those in the control group[(1.39±0.41)ng/L,(11.72±9.58)ng/L,(2.16±0.65)ng/L,t=8.040,16.982,7.825,all P<0.05].Serum levels of interleukin-6 and interleukin-10 in the bacterial plus viral infection group were(4.10±1.09)ng/L and(66.64±7.42)ng/L,respectively,which were significantly higher than those in the control and simple viral infection groups(t=13.088,9.053,10.031,15.021,all P<0.05).Serum C-reactive protein level in the bacterial plus viral infection group was significantly higher than that in the simple viral infection group[(26.28±4.35)mg/L vs.(10.91±1.16)mg/L,t=21.938,P<0.05].Serum procalcitonin level and white blood cell counts in the bacterial plus viral infection group were(0.63±0.04)μg/L,(15.12±3.97)×10^(9)/L,respectively,which were significantly higher than those in the control group[(0.13±0.02)μg/L,(7.93±1.91)×10^(9)/L,both P<0.05]and s

关 键 词：手足口病 细菌感染 降钙素原 C反应蛋白质 白细胞计数 早期检测 儿童 

分 类 号：R725.1[医药卫生—儿科]