血清降钙素原与C-反应蛋白和白细胞介素-18诊断急性上呼吸道感染患儿的临床研究

Clinical research on serum PCT,CRP and IL-18 for diagnosis of acute upper respiratory tract infections in children

目的血清降钙素原(PCT)、C-反应蛋白(CRP)和白细胞介素-18(IL-18)在急性上呼吸道感染的诊断临床应用价值,为临床治疗提供参考依据。方法选取医院2011年4月-2012年4月收治的急性上呼吸道患儿共143例作为观察组,同时选择同期健康的体检儿童作为对照组;对比两组儿童血清中PCT、CRP和IL-18的水平,分别观察两组儿童体内含量差异,以及血清PCT、CRP和IL-18在细菌感染患儿中的效能评价以及治疗前后的动态变化,采用SPSS17.0进行统计分析。结果观察组中细菌感染患儿血清PCT为(1.25±0.31)ng/ml、CRP为(16.1±5.22)mg/L、IL-18为(128±12.4)ng/ml;其水平均明显高于对照组儿童以及病毒感染患儿;PCT的ROC曲线下面积从高到低分别是PCT的96.8%、CRP的90.8%及IL-18的69.2%。结论对患儿急性上呼吸道感染可以采用PCT进行诊断,其特异性和敏感性相对较高,诊断结果可靠。

OBJECTIVE To evaluate the value of serum PCT, CRP and IL-18 in the diagnosis of acute upper respiratory tract infections so as to provide reference for clinical treatment. METHODS Totally 143 children with acute upper respiratory tract infections admitted in our hospital from Apr. 2011 to Apr. 2012 were selected as the observation group, and healthy children conformed by physical examinations during the same period were selected as the control group. Serum PCT, CRP and IL-18 levels and contents were compared between the two groups of children. Potency and dynamic changes of serum PCT, CRP and IL-18 before and after treatment in children with bacterial infection were evaluated. RESULTS Serum PCT, CRP and IL-18 was （1.25±0. 31） ng/ml, （16.1±5.22） mg/L, and （128± 12.4） ng/ml in the bacterial infected children in the observation group. The contents were sig- nificantly higher than in the control group and the children with viral infection. The area under the ROC curve for PCT ranking from high to low was 96.8% of PCT, 90.8% of CRP and 69.2% of IL-18. CONCLUSION Acute upper respiratory tract infection can be diagnosed using PCT, as it has relatively high sensitivity and specificity, the diagnostic results are reliable.