PCT、HsCRP在儿童不明原因发热性疾病中的诊断意义

The clinical significance of detecting serum PCT and HsCRP level on the diagnosis of unknown feverin childeren

目的探讨发热患儿血清降钙素原(PCT)及高敏C-反应蛋白(HsCRP)水平在儿童不明原因发热性疾病诊断中的意义。方法对本院住院的172例发热患儿进行回顾性分析,根据出院时的诊断结果将其分为细菌感染组(n=88)、非细菌感染组(n=61)和非感染组(n=23);同时,将同期在本院体检的健康儿童作为对照组(n=42)。对各组儿童进行PCT、HsCRP检测。结果细菌感染组PCT值为(2.14±1.01)μg/L,明显高于非细菌感染组的(0.09±0.15)μg/L和非感染组的(0.15±0.12)μg/L,差异有统计学意义(P<0.05),也高于对照组的(0.08±0.05)μg/L,差异有统计学意义(P<0.05);非细菌感染组、非感染组和对照组血清PCT差异无统计学意义(P>0.05)。细菌感染组HsCRP值为(38.2±10.1)mg/L,明显高于非细菌感染组的(2.60±1.58)mg/L和非感染组的(15.3±10.2)mg/L,差异有统计学意义(P<0.05),也高于对照组的(5.0±1.1)mg/L,差异有统计学意义(P<0.05)。以PCT≥0.5μg/L为诊断细菌感染的阳性阈值,其诊断敏感性为77.3%,诊断特异性为94.0%;以HsCRP≥5.0 mg/L为诊断细菌感染的阳性阈值,其诊断敏感性为81.8%,诊断特异性为50%,PCT的特异性明显高于HsCRP。结论检测血清PCT和HsCRP对发热性儿童患者细菌感染和非细菌性感染具有重要的鉴别意义。

Objectlve To evaluate the value of serum procalcitonin （PCT） and high sensitivity C-reactive protein （HsCRP） analysis in the differentiation of fever of unknown cause in children. Methods Information from 172 patients was retrospectively analyzed. The patients were divided into bacterial infection group （88）, non-bacterial infection group （61）, non-infection group （23） and the control group （42）. The levels of PCT and HsCRP were measured. Results The level of PCT in the bacterial infection group （2.14＋1.01） ~g/L was higher than the non-bacterial infection group [ （0.09＋-0.15）lxg/L,P〈0.05], non-infection group [ （0.15＋0.12）lxg/L,P〈0.05] and the control group [ （0.08＋0.05） IJ.g/L,P〈0.05 ]. The level of HsCRP level in the bacterial infection group （38.2＋10.1）I^g/L was higher than the non- bacterial infection group [ （2.60~ 1.58 ） Ixg/L, P〈0.05 ], non-infection group [ （ 15.3 ~ 10.2） I^g/L, P〈0.05 ] and the control group [（5.0~l.1）txg/L,P〈0.05]. There was no significant difference in the serum PCT level among the non-bacterial infection, non-infection and control group （P〈0.05）. If the positive threshold of diagnosing bacterial infection was defined as I〉 0.5 g/L of PCT, the sensitivity and specificity was 77.3% and 94.0%, respectively. If it was defined as I〉 5 mg/L of HsCRP, the sensitivity and specificity was 81.8% and 50%, respectively.The specificity of PCT for diagnosing bacterial infection was significantly higher than CRP （P〈0.05）. Conclusion Detecting serum PCT and HsCRP has an important value over HsCRP in the diagnosis of the unknown fever in children.