血清降钙素原与前白蛋白及C-反应蛋白对儿童感染诊断应用的评价

Application evaluation of serum procalcitonin,prealbumin,and C-reactive protein in clinical diagnosis of the children′s hospital infections

目的分析C-反应蛋白(CRP)、血清前白蛋白(PA)、血清降钙素原(PCT)对儿童医院感染诊断中的应用以及评价关系,为临床检查及治疗提供帮助。方法对2012年4月-2013年10月医院儿科收治的81例医院感染患儿进行观察,并与同期随机抽取的100名体检正常儿童进行对比分析,比较两组患儿的CRP、PA、PCT,以及感染患儿治疗前后变化情况,采用SPSS 17.0软件进行统计分析。结果感染患儿治疗前CRP与PCT浓度明显高于对照组,而PA浓度明显低于对照组,差异有统计学意义(P<0.05);治疗一周后感染组CRP与PCT浓度大幅降低,PA浓度显著升高,治疗前、后CRP、PA、PCT比较差异有统计学意义(P<0.05);cutoff值CRP为0.81mg/L、PA为9.20mg/L、PCT为0.14μg/L;联合应用检测敏感度提高至97.4%,特异性提高至98.5%。结论CRP、PA、PCT检测对儿童医院感染的临床诊断具有较高的特异性及敏感性,联合动态检测不仅能提高感染性疾病的早期诊断,而且还能反映感染程度及治疗效果,值得临床推广和应用。

OBJECTIVE To analyze the application of C-reactive protein,serum prealbumin,serum procalcitonin on the treatment of children′s hospital infections so as to provide assistances for clinical examination and treatment.METHODS From Apr.2012 to Oct.2012,81 cases of pediatric patients with hospital infections were observed,and compared with normal children with a random sample of 100.The level of C-reactive protein（CRP）,serum prealbumin（PA）,serum calcitonin（PCT）,and the changes of children′s health before and after the treatments were compared.All data were statistically analyzed by SPSS 17.0software.RESULTS The PCT and CRP concentration in the infected children group before the treatment was significantly higher than the control group,and PA concentration was significantly lower than the control group（P〈0.05）;after a week＇s treatment,the PCT and CRP concentration was significantly reduced in the infection group,and PA concentration was apparently increased.The differences among CRP,PA and PCT were statistically significant before and after the treatment（P〈0.05）.CRP examination of the cutoff value was 0.81mg/L,PA examination of the cutoff value was 9.20mg/L,and PCT examination of cutoff value was 0.14μg/L.The combined application of them increased the detection rate by 97.4% and specificity by 98.5%.CONCLUSION Detection of C-reactive protein,serum prealbumin,and procalcitonin can be specific and sensitive to the clinical diagnosis of children＇s hospital infections and combined dynamic detection can not only improve the early diagnosis of infectious diseases but also can reflect the degree of infection and therapeutic effect.Hence the method is worthy to be promoted and applied.