痰液降钙素原检测在儿童细菌性下呼吸道感染的价值

The value of detecting procalcitonin in sputum in children with bacterial lower respiratory tract infection

目的分析儿童细菌性下呼道感染应用痰液降钙素原检测的价值。方法选取2017年1月至2017年12月间本院收治的细菌性下呼吸道感染患儿作为研究对象,分为轻度肺炎组、重度肺炎组及急性支气管炎组,每组各收集30例。检测各组患儿血清及痰液的降钙素原水平,分析各组检测阳性率及降钙素原浓度与患儿预后的关系,并且比较血清与痰液标本的检测灵敏度及特异度。结果轻度肺炎组和支气管炎组患儿痰液PCT的阳性率明显高于血清PCT阳性率,差异有统计学意义(P <0. 05);痰液PCT浓度高组患儿的发热、咳嗽及肺部体征消失时间、抗生素使用时间及住院时间明显较长;痰液PCT诊断下呼吸道感染的灵敏度(98. 80%vs86. 76%)及特异度(80. 0%vs77. 30%)明显高于血清PCT。结论痰液PCT测定对于早期诊断下呼吸道细菌感染具有重要的应用价值和潜力,值得临床进一步探索研究。

Objective To investigate the detection value of sputum procalcitonin in children with bacterial lower respiratory tract infection. Methods The patients with bacterial lower respiratory tract infection in our hospital were selected as the research object and divided into mild pneumonia group,severe pneumonia group and acute bronchitis group. Each group was collected in 30 cases. The serum and sputum levels of calcitonin were detected in each group. The positive rate of each group and the relationship between the concentration of procalcitonin and the prognosis of children was analyzed. The sensitivity and specificity of serum and sputum samples were compared. Results The positive rate of sputum PCT in mild pneumonia group and bronchitis group is significantly higher than that in serum PCT positive rate,the difference is statistically significant. The time of fever,cough and pulmonary signs disappeared,the application time of antibiotics and hospitalization time were significantly longer in children with high PCT concentration. The sensitivity（ 98.80% vs 86. 76%） and specificity（ 80. 0% vs 77. 30%） of sputum PCT for diagnosis of lower respiratory tract infection were significantly higher than those of serum PCT. Conclusion The measurement of sputum PCT has important application value and potential for early diagnosis of lower respiratory tract bacterial infection,which is worthy of further exploration in clinic.