降钙素原及C反应蛋白在儿科感染性疾病中的临床价值

Clinical value of procalcitonin and C-reactive protein in diagnosis of infectious disease in pediatric department

目的探讨降钙素原(PCT)、C反应蛋白(CRP)在儿科感染性疾病诊断中的临床价值,为儿科感染性疾病的鉴别诊断提供参考。方法选取儿科收治的疑似感染性疾病患儿258例,根据出院诊断分为细菌感染组176例、病毒感染组46例及非感染组36例,细菌感染组又根据病情严重程度分为局部细菌感染组143例及重症细菌感染组33例,对患儿在入院时分别以光化学发光法和免疫比浊法检测PCT、CRP。结果 PCT、CRP检测定量值细菌感染组分别为(6.21±5.70)ng/ml、(19.42±8.72)mg/L,病毒感染组分别为(0.21±0.15)ng/ml、(10.13±1.58)mg/L,非感染分别为(0.13±0.1)ng/ml、(7.12±0.73)mg/L,阳性率细菌感染组分别为71.59%、67.05%,病毒感染组分别为6.52%、10.87%,非感染组分别为8.33%、16.67%,PCT、CRP定量值细菌感染组、病毒感染组与非感染组比较、细菌感染组与病毒感染组比较,差异均有统计学意义(P<0.05),PCT、CRP阳性率细菌感染组与非感染组比较、与病毒感染组比较,差异均有统计学意义(P<0.05);PCT、CRP检测定量值局部细菌感染组分别为(1.53±1.02)ng/ml、(17.97±4.16)mg/L,重症细菌感染组分别为(7.43±4.48)ng/ml、(21.32±8.47)mg/L,阳性率局部细菌感染组分别为50.35%、59.44%,重症感染组分别为100.00%、90.91%,PCT、CRP定量值及阳性率两组比较差异均有统计学意义(P<0.05)。结论 PCT、CRP均能用于辅助诊断儿科感染性疾病,CRP灵敏性较高、特异性差,PCT灵敏性不及CRP,但特异性较高,用于细菌性与病毒性感染、细菌性感染严重程度的鉴别具有较高的临床价值。

OBJECTIVE To investigate the clinical value of procalcitonin（PCT） and C-reactive protein（CRP） in the diagnosis of infectious disease in pediatrics department so as to provide reference for the diagnosis and identification of the infectious diseases in the pediatrics department.METHODS A total of 258children suspected for infectious disease were enrolled in the study and were divided into the bacterial infection group with 176cases,the virus infection group with 46cases,and the non-infection group with 36cases according to according to the discharge diagnosis,and the patients in the bacterial infection group were divided into the local bacterial infection group with 143cases and the severe bacterial infection group with 33cases according to the illness severity.The PCT and CRP were detected on the admission to the hospital by photochemical luminous method and immune turbidimetric method.RESULTS The uantitative value of the PCT and CRP of the bacterial infection group were respectively（6.21±5.70） ng / ml and（19.42±8.72） mg / L,the virus infection group（0.21±0.15） ng / ml and（10.13±1.58） mg / L,the non-infection group（0.13±0.10） ng / ml and（7.12±0.73） mg / L;the positive rates of the bacterial infection group were respectively 71.59%and 67.05%,the virus infection group 6.52% and 10.87%,the noninfection group 8.33%and 16.67%,the difference in the quantitative value of PCT or CRP between the bacterial infection group,the virus infection group,and the non-infection group was statistically significant（P〈0.05）,the difference in the positive rate of PCT or CRP between the bacterial infection group,the virus infection group,and the non-infection group was statistically significant（P〈0.05）;the quantitative value of detection of PCT and CRP of the local bacterial infection group were respectively（1.53±1.02） ng / ml and（17.97±4.16） mg / L,the severe bacterial infection group（7.43±4.48） ng / ml and（21.32±8.47） mg / L;the positive rates of the local bacterial infection group were respectively 50.35% and 59.44%,the severe bacterial infection group 100.00% and 90.91%,the difference in the quantitative value or the positive rate of PCT or CRP between the two groups was statistically significant（P〈0.05）.CONCLUSION Both PCT and CRP can be used for auxiliary diagnosis of pediatric infectious disease,with CRP of high sensitivity and poor specificity,the PCT of low sensitivity and high specificity,which have high clinical value in distinguishing between the bacterial infection and the virus infection as well as the severity of bacterial infections.