前清蛋白、降钙素原及白细胞计数在诊断小儿重症肺炎中的作用

Role of prealbumin, procalcitonin, and white blood cell count in diagnosis of severe pneumonia in children

目的探讨血清中前清蛋白、降钙素原及白细胞计数在小儿重症肺炎诊断中的指导意义。方法将本院2015年2月至2016年6月住院的204例肺部感染患儿依据病情严重程度分为重症肺炎组和非重症肺炎组，随机选取本院同期行健康体检儿童50例作为对照组，比较重症肺炎、非重症肺炎患儿与健康儿童PAB、PCT和WBC水平的差异。结果重症肺炎组患儿PCT和WBC水平均明显高于非重症肺炎组与对照组，PAB水平显著低于非重症肺炎组与对照组，差异均有统计学意义（均P〈0．05）；重症肺炎组患儿PCT和WBC阳性率均明显高于非重症肺炎组与对照组，差异均有统计学意义（均P〈0．05）；PAB阳性率稍低于非重症肺炎组，但差异无统计学意义（P〉0．05）；PCT的Youden指数为0．415，ROC曲线下面积0．821，灵敏度63．5％、特异度76．8％，优于PAB和WBC。结论PCT可作为小儿重症肺炎诊断的有效指标，并同时参考WBC与PAB水平变化，以便更为周全的鉴别诊断。

Objective To investigate the significance of serum prealbumin, procalcitonin, and white blood cell count in the diagnosis of severe pneumonia in children. Methods 204 children with pulmonary infection hospitalized at our hospital from February, 2015 to June, 2016 were divided into a severe pneumonia group and a non-severe pneumonia group according to the severity of the disease. The levels of PAB, PCT and WBC were compared among the children with severe pneumonia, those with non-severe pneumonia children, and healthy children. Results The levels of PCT and WBC were significantly higher and the PAB level was significantly lower in the severe pneumonia group than in the non-severe pneumonia group and the control group（ all P 〈 0.05 ） . The positive rates of PCT and WBC were significantly higher in the severe pneumonia group than in the non-severe pneumonia group and the control group （ P 〈 0.05 ） . The positive rate of PAB was slightly lower the severe pneumonia group than in the non-severe pneumonia group, but the with no statistical difference（ P 〉 0.05 ） . The Youden index of PCT was 0.415; the area under ROC curve was 0.821; the sensitivity was 63.5%; and the specificity was 76.8%; which were better than those of PAB and WBC. Conclusions PCT can be used as an effective indicator in the diagnosis of severe pneumonia in children; and with the reference to the changes of WBC and PAB levels, the differential diagnosis will be more comprehensive.