CD64和降钙素原在小儿细菌性腹泻早期诊断中的价值探讨

Exploration on value of CD64 and procalcitonin in early diagnosis of pediatric bacterial diarrhea

目的检测腹泻患儿外周血中性粒细胞CD64指数和降钙素原(PCT)水平,探讨其在儿童腹泻鉴别诊断中的意义。方法选取2012年7月至2014年5月该院收治的180例腹泻患儿为研究对象,并将其分为细菌性腹泻组(60例),病毒性腹泻组(60例),非感染性腹泻组(60例)。检测3组患儿外周血中性粒细胞CD64指数和PCT表达水平,并分析两者对小儿腹泻的诊断价值。结果细菌性腹泻组患儿外周血CD64指数和PCT水平均高于病毒性腹泻组和非感染性腹泻组;且细菌性腹泻组CD64和PCT检测阳性率也高于其他两组,差异均有统计学意义(P<0.05)。CD64指数对细菌性腹泻诊断的特异度和阳性预测值均高于PCT,差异均有统计学意义(P<0.05)。相关性分析显示,细菌性腹泻患儿外周血中性粒细胞CD64指数和PCT水平呈正相关(r=0.865,P<0.05)。结论细菌性腹泻患儿外周血中性粒细胞CD64指数和PCT水平均有明显升高,CD64和PCT检测对儿童细菌性腹泻的早期诊断具有重要的参考价值。

Objective To detect peripheral blood neutrophil CD64 and procalcitonin（PCT）in children with diarrhea,and to explore significance for differential diagnosis of diarrhea in children.Methods A total of 180 cases of children with diarrhea treated in this hospital from July 2012 to May 2014 were selected as subjects,and were classified into three groups：bacterial diarrhea group（n=60）,viral diarrhea group（n=60）and non infectious diarrhea group（n=60）.The levels of peripheral blood neutrophil CD64 and PCT were determined in all three groups,and the diagnostic values of CD64 index and PCT were evaluated.Results The peripheral blood neutrophil CD64 index and level of PCT in the bacterial diarrhea group were significantly higher than those in the viral diarrhea group and non infectious diarrhea group,and the positive rates of CD64 index and PCT in the bacterial diarrhea group were significantly higher than those in the viral diarrhea group and non infectious diarrhea group,all had statistically significant differences（P〈0.05）.The specificity and positive predictive value of CD64 index in diagnosing bacterial diarrhea were significantly higher than those of PCT,both had statistically significant differences（P〈0.05）.The relative analysis showed that the CD64 index was positively correlated with level of PCT（r=0.865,P〈0.05）.Conclusion The CD64 index and PCT level of children with bacterial diarrhea increase significantly,which indicates that the detection of CD64 index and PCT have significant clinical value in early diagnosis of bacterial diarrhea.