IL-6、IL-8、CRP、PCT联合检测在儿童感染性疾病中的诊断价值及临床可报告范围研究  

Research on diagnostic value and clinical reportable range for combined detection on IL-6,IL-8,CRP and PCT in childhood infectious diseases

作　　者：赵睿 袁昆 张跃栋 程丽萍 姜志锋 孙永锋 ZHAO Rui;YUAN Kun;ZHANG Yue-dong;CHENG Li-ping;JIANG Zhi-feng;SUN Yong-feng(Fengfeng General Hospital of North China Healthcare Group,Handan,Hebei 056200,China)

机构地区：[1]华北医疗健康集团峰峰总医院,河北邯郸056200

出　　处：《医学动物防制》2022年第2期197-200,共4页Journal of Medical Pest Control

基　　金：河北省卫生健康委科研项目(20201263)。

摘　　要：目的探讨白细胞介素6(interleukin 6,IL-6)、白细胞介素8(interleukin 8,IL-8)、C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)在儿童感染性疾病诊断中的价值,并对其临床可报告范围进行研究。方法收集2016年4月—2020年10月来某院就诊的感染性疾病患儿378例作为实验观察组,按照感染程度不同分为重症感染组和轻症感染组,并选择189例健康体检儿童作为对照组。分别对各组进行血清IL-6、IL-8、CRP、PCT的检测,验证各检测项目分析测量范围(analysis measurement range,AMR),确定临床可报告范围(clinical reportable range,CRR)。通过Logistic回归及受试者工作特征曲线(receiver operating characteristic curve,ROC)分析,评估4种检测指标对儿童感染性疾病的诊断价值。结果采用方差分析对重症感染组、轻症感染组和对照组之间IL-6、IL-8、CRP、PCT检测水平进行比较,各组之间差异有统计学意义(F=13.29、19.39、14.33、23.59,P均<0.05)。IL-6、IL-8、CRP、PCT的临床可报告范围分别为3~3990 pg/ml、3~3890 pg/ml、0.50~123.98 mg/L、0.02~183.51 ng/ml。Logistic分析及ROC曲线分析结果表明该实验检测模型与儿童感染性疾病拟合度较好,联合检测的诊断意义大于单项检测,L-6、IL-8、CRP、PCT的最佳诊断点分别为25.3 pg/ml、26.7 pg/ml、23.5 mg/L、0.89 ng/ml。结论血清IL-6、IL-8、CRP、PCT可作为诊断儿童感染性疾病诊断的血清标志物,4种指标联合检测可提高诊断效能,临床可报告范围为临床诊疗提供重要参考。Objective To explore the value of interleukin 6(IL-6),interleukin 8(IL-8),C-reactive protein(CRP)and procalcitonin(PCT)in the diagnosis of infectious diseases in children,and to study clinically reportable range of four test items.Methods Three hundred and seventy eight children with infectious diseases visiting some sospital from April 2016 to October 2020 were included in the experimental observation group,divided into severe infection group and mild infection group based on the degree of infection.Another 189 healthy children were enrolled in the control group,and serum IL-6,IL-8,CRP and PCT of children in groups were tested to verify the analysis measurement range(AMR)and determine clinical reportable range(CRR).The diagnostic value of 4 detection indicators on childhood infectious diseases were evaluated through Logistic regression and receiver operating characteristic curve(ROC curve)analysis.Results The detection level of IL-6,IL-8,CRP,and PCT of patients among the severe infection group,mild infection group and control group were compared through the variance analysis,and the difference was statistically significant(F=13.29,19.39,14.33,23.59,all P<0.05).CRR of IL-6,IL-8,CRP,and PCT was 3-3990 pg/ml,3-3890 pg/ml,0.50-123.98 mg/L and 0.02-183.51 ng/ml respectively.Logistic and ROC curve analysis results showed that the experimental detection model fitted appropriately with children′s infectious diseases,the diagnostic significance of combined testing was greater than that of single testing,and best diagnostic points for L-6,IL-8,CRP,and PCT were 25.3 pg/ml,26.7 pg/ml,23.5 mg/L and 0.89 ng/ml respectively.Conclusion Serum IL-6,IL-8,CRP,and PCT is eligible to be used as serum markers for diagnosis on childhood infectious diseases.The combined detection of four indicators can improve the diagnostic efficiency,and CRR provides an important reference for clinical diagnosis and treatment.

关 键 词：感染性疾病 白介素-6 白介素-8 C反应蛋白 降钙素原 

分 类 号：R725[医药卫生—儿科]