PCT、hs-CRP及IL-6对手足口病继发细菌感染诊断价值

THE VALUE OF PCT,HS-CRP AND IL-6IN THE DIAGNOSIS OF HAND-FOOT-MOUTH DISEASE WITH SECONDARY BACTERIAL INFECTION

目的探讨降钙素原（PCT）、超敏C反应蛋白（hs-CRP）及白细胞介素6（IL-6）在手足口病（HFMD）继发性细菌感染中的诊断价值。方法测定53例HFMD继发性细菌感染病儿（细菌感染组）、60例未继发细菌感染HFMD病儿（非细菌感染组）和54例健康儿童（正常对照组）的血清PCT、hs-CRP和IL-6水平,并进行比较,应用受试者工作特征曲线（ROC曲线）对上述指标进行诊断价值分析。结果与非细菌感染组和正常对照组比较,细菌感染组PCT、hs-CRP和IL-6水平均有不同程度升高（Z=2.309~7.826,P〈0.05、0.01）;与正常对照组比较,非细菌感染组hs-CRP和IL-6水平有不同程度升高（Z=6.759、6.383,P〈0.01）,而PCT在两组间的差异无统计学意义（P〉0.05）。PCT、hs-CRP和IL-6诊断HFMD继发性细菌感染的ROC曲线下面积分别为0.911、0.765和0.834,最佳临界值分别为0.063μg/L、10.500mg/L、15.890ng/L,诊断灵敏度分别为81.1%、73.6%和84.9%,诊断特异度分别为95.6%、80.7%和71.1%。结论在HFMD继发性细菌感染的诊断中,IL-6的灵敏度最高,而PCT的特异度最高;相比hs-CRP和IL-6,PCT的诊断价值更大。

Objective To assess the value of procalcitonin（PCT）,hypersensitive C-reactive protein（hs-CRP）and interleukin 6（IL-6）for the diagnosis of hand-foot-mouth disease（HFMD）with secondary bacterial infection. Methods Serum PCT,hs-CRP and IL-6levels in 53 HFMD children with secondary bacterial infection（bacterial infection group）,60 HFMD children without secondary bacterial infection（non-bacterial infection group）,and 54 healthy children（normal control group）were determined and compared,using receiver operating characteristic（ROC）curve to analyze the diagnostic significance of these indicators.Results As compared with the non-bacterial infection group and normal control group,PCT,hs-CRP and IL-6in the bacterial infection group were all increased to different extents（Z=2.309-7.826;P〈0.05,0.01）;compared with the normal control group,hs-CRP and IL-6in the non-bacterial infection group were increased（Z=6.759,6.383;P 〈0.01）,and there was no statistical difference in PCT between the two groups（P〉0.05）.The areas of PCT,hs-CRP and IL-6under the ROC curve for the diagnosis of HFMD with secondary bacterial infection were 0.911,0.765 and 0.834,respectively,with the optimal cut-off values were0.063μg/L,10.500mg/L and 15.890ng/L,respectively,and the sensitivity was 81.1%,73.6%and 84.9%,respectively,and the specificity was 95.6%,80.7% and 71.1%,respectively. Conclusion In the diagnosis of HFMD with secondary bacterial infection,the sensitivity of IL-6being the highest,and the most specificity being PCT.Compared with hs-CRP and IL-6,the value of PCT is even greater.