血清降钙素原在儿童社区获得性肺炎的临床应用

Clinical application of serum procalcitonin in children with community-acquired pneumonia

目的：探讨降钙素原（PCT）在儿童社区获得性肺炎（CAP）细菌性感染和病毒性感染的鉴别诊断价值，并与C反应蛋白（CtKP）和白细胞计数（WBC）方法相比较，研究其在CAP诊断中的准确性和应用。方法：选取我院105例CAP患儿和正常对照组40例，105例CAP患儿中，根据细菌学培养结果分为细菌感染组（60例）和非细菌感染组（45例），检测PCT、CRP和WBC计数，并绘制各指标受试者工作曲线（ROC），比较各方法结果和在诊断CAP的准确性。结果：CAP患儿血清PCT、CRP和WBC明显高于正常对照组，差异有统计学意义fP〈0．05）；细菌性感染组PCT、CRP和WBC明显高于非细菌感染组，差异有统计学意义（P〈0．05）；通过ROC曲线比较。PCT在CAP诊断的曲线下面积（AUC）为0．92，敏感性为90．2％，特异性为96．1％，显著高于CRP（AUC为0．75，敏感性71．4％，特异性83．5％）和WBC（AUC为0．69，敏感性67．2％，特异性78．3％）。结论：本文研究发现血清PCT、CRP和WBC水平与细菌性感染密切相关，通过ROC曲线比较发现PCT在CAP患者中的鉴别诊断优于CRP和WBC，可为今后临床医生诊治CAP提供更多参考性依据。

objective： To evaluate the differential diagnostic value of procalcitonin （PCT） in children with community-acquired pneumonia （CAP） of bacterial infection and viral infection, and study the accuracy and application of PCT in the diagnosis of CAP, compared with c-reactive protein （CRP） and white blood count （WBC） .Methods： 105 cases of children with CAP and 40 cases of normal control were chosen. 105 cases of children with CAP were divided into bacterial infection group （60 cases） and non bacterial infection group （45 cases） according to the results of bacteriological culture. PCT,CRP and WBC count were detect- ed and ROC curve was draw to compare the accuracy in the diagnosis of CAP.Results： Serum PCT, CRP and WBC in CAP group were significandy higher than those of control group （P〈0.05） . Serum PCT, CRP and WBC in bacterial infection group were sig- nificantly higher than those of non-bacterial infection group （P〈0.05） . Based on ROC analysis, area under curve （AUC） of PCT was 0.92, with sensitivity of 90.2% and specificity of 96.1%, significantly higher than CRP （AUC 0.75, sensitivity 71.4%, specificity 83.5%） and WBC （AUC 0.69, sensitivity 67.2%, specificity 78.3%） Conclusion： Serum PCT, CRP and WBC levels are closely re- lated to the bacterial infection. Differential diagnosis value of PCTin patients with CAP is better than CRP and WBC, providing more reference basis for clinical diagnosis and treatment of CAP.