全血C-反应蛋白与血常规联合检测对儿童细菌感染性疾病的诊断价值

Diagnostic significance of whole blood C-reactive protein combined with routine blood tests in pediatric bacterial infectious diseases

目的探讨全血C-反应蛋白(CRP)与血常规联合检测在儿童细菌感染性疾病中的诊断价值。方法收集2015年1月12日—2017年3月12日在德州联合医院就诊的120例细菌感染性疾病患儿的血液标本,根据检测方法的不同将其分为常规检测组(单纯进行血常规检测)和联合检测组(进行全血CRP与血常规联合检测),每组各60例。比较两组患儿各类型感染(包括肺炎、肠炎、脑膜炎、尿路感染等)的疾病检出率以及诊断准确率,并进行统计学分析。结果与常规检测组比较,联合检测组患儿肺炎、肠炎、脑膜炎、尿路感染的检出率明显升高[肺炎:93.3%(14/15)比62.5%(10/16),χ~2=4.210 2,P=0.040 1;肠炎:93.3%(14/15)比46.7%(7/15),χ~2=7.777 8,P=0.005 3;脑膜炎:91.7%(11/12)比38.5%(5/13),χ~2=7.666 7,P=0.005 6;尿路感染:92.3%(12/13)比50.00%(6/12),χ~2=5.540 3,P=0.018 6],其他类型疾病的检出率联合检测组也高于常规检测组[1.0%(5/5)比0%(0/4),χ~2=9.000 0,P=0.002 7],总诊断准确率明显升高[93.33%(56/60)比46.67%(28/60),χ~2=31.111 1,P=0.000 0]。结论对细菌感染性疾病患儿进行血常规与全血CRP联合检测,可保证较高的阳性检出率和诊断准确率,从而指导该疾病的临床诊断与治疗,值得采纳。

Objective To explore the diagnostic value of combined whole blood C-reactive protein（CRP） and blood routine detections in children with bacterial infectious diseases. Methods Blood samples of 120 children with bacterial infectious diseases treated at Dezhou United Hospital from January 12, 2015 to March 12, 2017 were collected. According to difference in detection methods, they were divided into routine test group（blood routine test only） and combined test group（whole blood CRP combined with blood routine test）, 60 cases in each group. The rates of disease detection and the diagnostic accuracy of each type of infection（including pneumonia, enteritis, meningitis, urinary tract infection, etc.） were compared between the two groups, and statistical analyses were performed. Results Compared with the conventional test group, the detection rates of pneumonia, enteritis, meningitis and urinary tract infection were significantly higher in the combined test group [pneumonia： 93.3%（14/15） vs. 62.5%（10/16）, χ^2 = 4.210 2, P = 0.040 1; enteritis： 93.3%（14/15） vs. 46.7%（7/15）, χ^2 = 7.777 8, P = 0.005 3; meningitis： 91.7%（11/12） vs. 38.5%（5/13）, χ^2 = 7.666 7,P = 0.005 6; urinary tract infection： 92.3%（12/13） vs. 50.00%（6/12）, χ^2 = 5.540 3, P = 0.018 6], the detection rate of other types of disease was also higher in the combined test group than that in the conventional test group [1.0%（5/5） vs. 0%（0/4）, χ^2 = 9.000 0, P = 0.002 7], and the total diagnostic accuracy was also significantly higher in the combined group [93.33%（56/60） vs. 46.67%（28/60）, χ^2 = 31.111 1, P = 0.000 0]. Conclusion The combined blood routine and whole blood CRP test can ensure high positive detection rates and total diagnostic accuracy of various bacterial infectious diseases, so as the combined method can guide the clinical diagnosis and treatment of these diseases, and it is worthy for clinical adoption.