CRP、PCT、WBC联检对儿童社区获得性肺炎严重程度的预测

Predictive Values of Combined Detection of CRP,PCT and WBC in Children with Community Acquired Pneumonia

目的探讨血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)联合检测在儿童社区获得性肺炎(CAP)病情程度预测中的应用价值.方法选取我院CAP患儿103例为研究组,另选取同期健康体检者103例为对照组.入院后第2 d晨起测定血清CRP、PCT、WBC水平.比较研究组与对照组、不同病情程度CAP血清PCT、CRP、WBC水平,Person检验分析血清PCT、CRP、WBC水平与CAP病情程度相关性,比较PCT、CRP、WBC各指标单独与联合诊断CAP的价值.结果研究组血清PCT、CRP、WBC水平高于对照组(P<0.05);重度患儿血清PCT、CRP、WBC水平高于轻度患儿(P<0.05);血清PCT(r=0.890)、CRP(r=0.872)、WBC(r=0.868)水平与CAP病情程度存在明显正相关(P<0.05);联合诊断的敏感度(98.06%)、准确度(94.17%)高于PCT、CRP、WBC单独诊断;联合诊断与PCT诊断的特异度(90.29%与90.29%)高于CRP及WBC单独诊断.结论 PCT、CRP、WBC联合检测可有效提高诊断及病情严重程度的敏感度、特异度及准确度的判断,为临床诊断及制定针对性干预方案提供依据.

Objective To investigate predictive values of combined detection of serum calcitonin( PCT),C reactive protein( CRP) and white cell count( WBC) in children with community acquired pneumonia( CAP). Methods A total of 103 CAP children were selected as research group, and 103 healthy children were selected as control group at the same time. Levels of CRP, PCT and WBC were detected at the second day in hospital. Levels of CRP, PCT and WBC were compared between the two groups and among all order of severities. The correlation between levels of PCT, CRP and WBC and the severity of CAP were statistically analyzed. The values of combined diagnosis and single diagnosis of PCT,CRP and WBC in CAP were compared. Results The levels of serum PCT,CRP and WBC in the study group were higher than those in the control group( P < 0. 05). The levels of serum PCT, CRP and WBC in severe children were higher than those in mild children( P <0. 05 ). Levels of serum PCT( r = 0. 890), CRP( r = 0. 872 ), WBC (r = 0. 868) were positively correlated with the severity of CAP( P < 0. 05 ). The sensitivity (98. 06%) and accuracy (94. 17%)of combined diagnosis of PCT,CRP and WBC were higher than those of single diagnosis. The specificity of the combined diagnosis(90. 29%) and PCT diagnosis(90. 29%) were higher than those of single diagnosis of CRP and WBC. Conclusion The combined diagnosis of PCT, CRP and WBC can effectively improve diagnostic sensitivity accuracy an(l specificity, which can provide a reliable basis for clinical formulation of targeted intervention.