C-反应蛋白、血清前白蛋白及血常规联合检验在小儿细菌性感染性疾病诊断中的应用价值

Value on application of combined CRP,PA with blood routine inspection in diagnosis of bacterial infectious diseases in children

目的探讨C-反应蛋白（CRP）、血清前白蛋白（PA）以及血常规联合检验在小儿细菌性感染性疾病诊断中应用的价值。方法选取北京市昌平区妇幼保健院收治的确诊为感染性疾病患儿98例作为研究对象,其中细菌性感染性疾病患儿68例,将其记为细菌感染组,非细菌性感染性患儿30例,将其记为非细菌感染组,另选取50名健康儿童作为对照组,所有患儿及对照组儿童均给予CRP、PA以及血常规检测,根据检测结果评价诊断符合率。结果细菌感染组CRP、WBC水平显著高于非细菌感染组和对照组（P〈0.05）,细菌感染组PA水平显著低于非细菌感染组和对照组（P〈0.05）;以患儿尿液、脑脊液或痰液细菌培养结果作为金标准,检测结果为68例为真阳性,30例为阴性。CRP诊断阳性40例,阴性58例,13例为假阳性,41例为假阴性,检测灵敏度为39.71%,特异度为56.67%,诊断符合率为44.90%。PA诊断阳性43例,阴性55例,12例为假阳性,37例为假阴性,检测灵敏度为45.59%,特异度为60.00%,诊断符合率为50.00%。WBC诊断阳性47例,阴性51例,14例为假阳性,35例为假阴性,检测灵敏度48.53%,特异度为53.33%,诊断符合率为52.04%。CRP、PA、WBC联合诊断阳性62例,阴性36例,3例为假阳性,9例为假阴性,检测灵敏度为86.76%,特异度为90.00%,诊断符合率为87.76%。CRP、PA、WBC联合诊断的灵敏度、特异度、符合率均显著高于CRP、PA、WBC诊断结果,CRP、PA、WBC单独诊断的灵敏度、特异度、符合率无明显差异。结论对细菌性感染性患儿实施CRP、PA、WBC联合诊断能够有效提高诊断符合率,为临床治疗提供理论依据。

Objective To explore the value on application of combined C-reactive protein（ CRP）,serum albumin（ PA） with blood routine inspection in diagnosis of bacterial infectious diseases in children. Methods 98 cases of patients confirmed infectious diseases in our hospital were selected as the study objects,and 68 cases with bacterial infectious diseases were as the bacterial infection group,while 30 cases with non-bacterial infection were as the non-bacterial infection group. Another 50 cases of healthy children were as the control group. All the children and children in the control group were given CRP,PA and blood routine detection,The diagnostic coincidence rates were evakuated according to the examination results.Results CRP and WBC levels in the bacterial infection group were significantly higher than those in the non-bacterial infection group and the control group（ P 〈0. 05）,PA level in the bacterial infection group were significantly higher than that in the non-bacterial infection group and the control group（ P 〈0. 05）,The children＇s urine and cerebrospinal fluid or sputum bacterial culture results as the gold standard,68 cases were true positive,and 30 were negative. CRP diagnosis showed 40 cases were positive,58 cases negative,13 cases false positive,and 41 cases false negative,the detection sensitivity was 39. 71%,specificity was 56. 67%,and coincidence rate was 44. 90%. PA diagnosis showed 43 cases were positive,55 cases negative,12 cases false positive,and 37 cases false negative,the detection sensitivity was 45. 59%,specificity was 60. 00%,and coincidence rate was 50. 00%. WBC diagnosis showed 47 cases were positive,51 cases negative,14 cases false positive,and 35 cases false negative,the detection sensitivity was48. 53%,specificity was 53. 33%,and coincidence rate was 52. 04%. CRP,PA,WBC combined diagnosis showed 62 cases were positive,36 cases negative,3 cases false positive,and 9 cases false negative,the detection sensitivity was 86. 76%,specificity was 90. 00%,and coincidence rate was87. 76%. The sensitivity,specificity and coincidence rate of CRP,PA and WBC combined diagnosis were significantly higher than those of CRP,PA and WBC diagnosis results. There were no significant differences in sensitivity,specificity and coincidence rate among single diagnosis of CRP,PA and WBC. Conclusion Implementation of combined CRP,PA with WBC in diagnosis of bacterial infection in children can effectively improve diagnostic coincidence rate. and provide theoretical basis for clinical treatment.