手足口病继发细菌感染患儿检测降钙素原、超敏C反应蛋白及白细胞介素-6的临床意义

Clinical Significance of Procalcitonin,Hypersensitivity C Reactive Protein and Interleukin-6 in Children with Hand Foot Mouth Disease Secondary to Bacterial Infection

目的:探讨分析手足口病(HFMD)继发细菌感染患儿检测降钙素原、超敏C反应蛋白及白细胞介素-6的临床意义。方法:选取2016年1月-2017年4月本院收治的HFMD初诊患儿100例,根据其有无细菌感染分为对照组和研究组,对照组为HFMD未并发感染组,研究组为HFMD继发细菌感染患儿,对比分析检测两组的降钙素原(PCT)、超敏C反应蛋白(hs-CRP)及白细胞介素-6(IL-6)。结果:研究组患儿的hs-CRP和IL-6水平均高于对照组(P<0.05),但两组PCT比较差异无统计学意义(P>0.05);研究组PCT、hs-CRP和IL-6的阳性检出率均明显高于对照组,差异均有统计学意义(P<0.05);对研究组PCT、hs-CRP和IL-6诊断的ROC曲线下面积(AUC)分别为0.912、0.764和0.833,临界值为0.062 ng/m L、10.490 mg/L和15.870 pg/m L,诊断的特异度为95.5%、79.9%和72.1%,灵敏度为82.1%、73.9%和85.1%。PCT的特异度最高,诊断价值最大,IL-6的灵敏度最高,差异均有统计学意义(P<0.05)。结论:在对HFMD继发细菌感染患儿的诊断中,HFMD继发细菌感染患儿PCT、hs-CRP和IL-6水平均增高,根据ROC曲线显示PCT的特异度最高,诊断价值最大,IL-6的灵敏度最高,三个指标均可以作为诊断标准,值得推广和应用。

Objective:To investigate the clinical significance of procalcitonin,high sensitivity C reactive protein and interleukin-6 in children with HFMD secondary to bacterial infection.Method:From January 2016 to April 2017 in our hospital diagnosed 100 cases of children with HFMD secondary to bacterial infection were divided into the control group and the study group,the control group was HFMD without secondary to bacterial infection group,the study group was HFMD secondary to bacterial infection,procalcitonin(PCT),high sensitive C reactive protein(hs-CRP)and interleukin-6(IL-6)of two groups were detected and analyzed.Result:IL-6 and hs-CRP of the study group were higher than those of the control group(P<0.05),but there was no significant difference of PCT between two groups(P>0.05).The positive rate of PCT,hs-CRP and IL-6 of the study group were significantly higher than those of the control group,the differences were statistically significant(P<0.05).The diagnosis of ROC area under the curve(AUC)of PCT,hs-CRP and IL-6 in the study group were 0.912,0.764 and 0.833,the critical value were 0.062 ng/mL,10.490 mg/L and 15.870 pg/mL,the specificity were 95.5%,79.9%and 72.1%,the diagnostic sensitivity were 82.1%,73.9%and 85.1%.PCT had the highest specificity and diagnostic value of maximum,the sensitivity of IL-6 was the highest,the difference was statistically significant(P<0.05).Conclusion:In the diagnosis of HFMD in children with secondary bacterial infection,PCT,hs-CRP and IL-6 levels increase,according to the ROC curve of PCT showes the highest specificity and diagnostic value of maximum sensitivity of IL-6 is the highest,three indexes can be used as diagnostic criteria,is worthy of promotion and application.