5种炎性反应指标在鉴别幼儿急性上呼吸道感染中的临床意义

The diagnostic value of 5 inflammatory markers in children with acute upper respiratory tract infection

目的探讨降钙素原(PCT)、C-反应蛋白(CRP)、白细胞(WBC)、中性粒细胞计数(Neu C)、中性粒细胞-淋巴细胞比值(NLR)5种炎性反应指标在幼儿急性上呼吸道感染中的临床价值。方法收集2015年1月-11月首都医科大学昌平教学医院儿科就诊的急性上呼吸道感染幼儿322例,分为细菌组(133例)和病毒组(189例),同时选取60例健康幼儿作为健康对照组,分别测定5种炎性反应指标的含量,比较差异。应用受试者工作特征曲线(ROC)评价5种炎性反应指标对幼儿急性上呼吸道感染的诊断效能。结果 5种炎性反应指标在细菌组含量均高于病毒组和健康对照组,差异有统计学意义(P<0.01)。5种炎性反应指标的ROC曲线下面积分别为93.9%、84.2%、77.7%、81.0%、83.6%。PCT诊断的灵敏度、特异度均高于其他炎症指标。结论 5种炎性反应指标PCT、CRP、WBC、Neu C、NLR均可作为幼儿急性上呼吸道感染的炎症标记物,用于鉴别和辅助诊断细菌性感染。其中PCT诊断效能优于其他炎症指标。

Objective To investigate the clinical significance of serum proealcitonin（ PCT）, C -reactive protein（CRP）, white blood cell（WBC）, neutrophil count（NeuC） and neutrophil lymphocyte ratio （NLR） in children with acute upper respiratory tract infection. Methods 322 patients with acute upper respiratory infection, which were divided into bacteria group（ 133 cases） and viruses group（ 189 cases）, while 60 patients with healthy children were selected as the control group in our hospital from January to November 2015. Serum PCT, CRP, WBC, NeuC and NLR levels were measured and compared. Then ROC curve was adopted to study the diagnostic value of these 5 inflammatory markers. Results Serum PCT, CRP, WBC, NeuC and NLR levels in bacterial infection group were higher than those in virus infection group and control group, and the differences were statistically significant （P 〈 0.01 ）. The area under the curve （ ROC ） of the 5 inflammatory markers were 93.9%, 84.2%, 77.7%, 81.0% and 83.6%, respectively. The sensitivity and specificity of PCT were higher than other inflammatory markers. Conclusion PCT, CRP, WBC, NeuC and NLR can be used as the inflammatory markers in children with upper respiratory tract infection, which can be used to identify and assist the diagnosis of bacterial infections. The diagnostic efficacy of serum PCT is superior to other inflammatory markers.