血清降钙素原对手足口病患儿伴细菌感染的早期鉴别诊断价值

Effects of serum procalcitonin in children with hand-foot-and-mouth disease combined with bacterial infections in the early differential diagnosis

目的分析血清降钙素原(PCT)对手足口病患儿伴细菌感染的诊断价值,为早期感染鉴别诊断提供依据。方法选取2013年3月-2015年3月医院接受治疗的手足口患儿232例,根据是否合并细菌感染将232例患儿分为细菌感染组55例与非细菌感染组177例,选取同期健康体检20名儿童为对照组,所有均进行血清PCT、C-反应蛋白(CRP)和外周血白细胞(WBC)检查。结果细菌感染组PCT、CRP和WBC分别为(7.41±3.45)ng/ml、(16.26±4.47)mg/L和(15.56±5.73)×109/L,均明显高于非细菌感染组和对照组,差异有统计学意义(P<0.05);PCT阳性率细菌感染组为94.55%、非细菌感染组为3.95%、对照组为5.00%,细菌感染组PCT阳性率明显高于非细菌感染组和对照组,差异有统计学意义(P<0.05);PCT诊断准确度为87.84%、敏感度为92.81%、特异度为95.23%,均明显优于CRP和WBC。结论血清降钙素原有利于早期小儿手足口病伴细菌感染的鉴别诊断,值得临床参考。

OBJECTIVE To analyze the diagnostic value of serum procalcitonin in children with hand-foot-and-mouth disease combined with bacterial infections,and to provide the basis for early diagnosis.METHODS There were 232 cases of children with hand-foot-and-mouth disease who were selected from Mar.2013 to Mar.2015 in our hospital.They were divided into 55 cases of bacterial infections and 177 cases of non-bacterial infection group,depending on whether the disease was combined with bacterial infections.And 20 children who received health examination in the same period were selected for the control group.All patients were performed after admission serum procalcitonin（PCT）,C-reactive protein（CRP）and peripheral blood leukocytes（WBC）examination.RESULTS The PCT,CRP and WBC in bacterial infection group were respectively（7.41± 3.45）ng/ml,（16.26± 4.47）mg/L and（15.56±5.73）×10^9/L,which were significantly higher than those in non-bacterial infection group and control group,and the difference was significant（P〈0.05）.For PCT positive rate,bacterial infection was94.55%,non-bacterial infection rate was 3.95%,and control group was 5.00% PCT,so the rate of PCT positive bacterial infection group was significantly higher than that of non-bacterial infection group and of control group（P〈0.05）.The rate of PCT diagnostic accuracy was 87.84%,of sensitivity was 92.81% and of specificity was95.23%,all of which were significantly better than those of CRP and WBC.CONCLUSIONSerum procalcitonin is conducive to early diagnosis for children with HFMD combined with bacterial infections,and is worth for clinical reference.