【摘要】 目的探讨血清降钙素原(procalcitonin,PCT)和C-反应蛋白(C-reactive protein,CRP)检测在诊断儿童呼吸道感染性疾病中的诊断价值。方法选择2014年2月至2015年4月我院收治的呼吸道感染患儿76例,其中细菌性呼吸道感染患儿39例(细菌感染组),非细菌性病原体感染患儿37例(其他病原体感染组),并选择我院健康体检儿童29例为正常对照组,分别检测呼吸道感染患儿治疗前后及正常对照儿童血清PCT、CRP水平,对检测结果进行统计学分析。结果细菌感染组、其他病原体感染组和正常对照组间血清PCT、CRP检测结果差异均有统计学意义(H=61.603,58.959,P均<0.01)。细菌感染组血清PCT、CRP检测结果均显著高于其他病原体感染组和正常对照组(ZPCT=-5.950,-6.549,ZCRP=-5.674,-6.591,P均<0.01),其他病原体感染组血清PCT、CRP检测结果均显著高于正常对照组(ZPCT=-4.002,ZCRP=-3.708,P均<0.01),且差异均有统计学意义。细菌感染组治疗前血清PCT、CRP检测结果均显著高于治疗后,且差异均有统计学意义(ZPCT=-5.415,ZCRP=-5.428,P均<0.01);其他病原体感染组治疗前血清PCT、CRP检测结果均高于治疗后,且差异均有统计学意义(ZPCT=-4.565,ZCRP=-5.137,P均<0.01)。治疗后细菌感染组、其他病原体感染组及正常对照组三组间血清PCT、CRP检测结果差异均无统计学意义(H=3.026,1.531,P均>0.05)。细菌感染组、其他病原体感染组及正常对照组间血清PCT、CRP阳性率差异均有统计学意义(χ2=56.85,40.78,P均<0.05)。细菌感染组及其他病原体感染组血清PCT、CRP阳性率均高于正常对照组,且差异均有统计学意义(P均<0.05)。细菌感染组血清PCT、CRP阳性率均高于其他病原体感染组,且差异均有统计学意义(P均<0.05)。血清PCT、CRP及二者联合检测诊断儿童细菌性感染的受试者工作特征曲线下面积分别为0.928,0.919和0.952,灵敏度分别为89.7%,88.2%和87.2%,特异性分别为84.8%,87.3%和95.5%,Youden指数分别为0.745,0.755,0.827。结论血清PCT、CRP检测可用于儿童呼吸道感染性疾病的诊断及鉴别诊断,两者联合检测较单独检测具有相对更高的临床价值。更多还原

【Abstract】 Objective To explore the diagnostic value of procalcitonin(PCT) and C-reactive protein(CRP) testing for diagnosing respiratory tract infectious diseases in children. Methods 105 cases children in our hospital from February 2014 to April 2015 were enrolled in this study, which including 39 cases children with bacterial infection, 37 cases children with non-bacterial pathogen infection, and 29 healthy children as the controls. The serum PCT, CRP levels of before and after treatment of children with respiratory tract infectious diseases and healthy children were all detected. The results were analyzed statistically. Results There were statistical significance in the differences of PCT, CRP levels among bacterial infection group, non-bacterial pathogen infection group and control group(H= 61.603, 58.959, Pall< 0.01). The serum PCT, CRP levels of bacterial infection group were all higher than that of non-bacterial pathogen infection group and control group, the differences all had statistical significance(ZPCT=-5.950,-6.549, ZCRP=-5.674,-6.591,Pall< 0.01).The serum PCT, CRP levels of non-bacterial pathogen infection group were all higher than that of control group, and the differences all had statistical significance(ZPCT=-4.002, ZCRP=-3.708, Pall < 0.01). The serum PCT, CRP levels of bacterial infection group before treatment were all higher than that of after treatment, and the differences all had statistical significance(ZPCT=-5.415, ZCRP=-5.428, Pall< 0.01). The serum PCT, CRP levels of non-bacterial pathogen infection group before treatment were all higher than that of after treatment, and the differences all had statistical significance(ZPCT=-4.565, ZCRP=-5.137, Pall< 0.01). There were no statistical significance in the differences of PCT, CRP levels among after treatment of bacterial infection group, non-bacterial pathogen infection group and control group(H= 3.026, 1.531, Pall> 0.05). There were statistical significance in the differences of PCT, CRP positive rate among bacterial infection group, nonbacterial pathogen infection group and control group(χ2= 56.85,40.78, Pall < 0.05). The positive rates of PCT, CRP in bacterial infection group and non-bacterial pathogen infection group were all higher than that of control group, and the differences all had statistical significance(Pall< 0.05). The positive rates of PCT, CRP in bacterial infection group were all higher than that of non-bacterial pathogen infection group, and the differences all had statistical significance(Pall < 0.05). The area under receiver operating characteristic curve of PCT, CRP and combined detection in diagnosing respiratory tract infectious diseases were 0.928, 0.919 and0.952, respectively. The sensitivity of PCT, CRP and combined detection were 89.7%, 88.2% and 87.2%,specificity were 84.8%, 87.3% and 95.5%, Youden index were 0.745, 0.755 and 0.827, respectively. Conclusion The serum PCT and CRP detection can be used for diagnosing the children with respiratory tract infection. The joined detection method has relatively high clinical value compared with the two indexes testing lonely.更多还原