超敏C-反应蛋白、白细胞计数及中性粒细胞比值在呼吸道感染患儿中的诊断价值

Diagnostic Value of High Sensitivity C-reactive Protein, White Blood Cell Count and Neutrophil Ratio in Children with Respiratory Tract Infection

目的:探讨研究超敏C-反应蛋白、白细胞计数及中性粒细胞比值在呼吸道感染患儿中的诊断价值。方法:系统性回顾2015年10月~2018年3月来某院儿科就诊的100例呼吸道感染患儿,根据感染病原体的种类分为细菌感染组和非细菌感染组,每组50例患儿,同期选取50名体检健康的儿童编入健康对照组。所有入选本次研究的患儿及健康儿童均于清晨空腹采集静脉血检测超敏C-反应蛋白和血常规,测定Hs-CRP、白细胞计数及中性粒细胞比值,并对比Hs-CRP、WBC与中性粒细胞诊断上呼吸道感染的敏感性和特异性。结果:细菌感染组患儿的Hs-CRP水平、WBC与中性粒细胞比值明显高于非细菌组及健康对照组病例的Hs-CRP的水平(P<0.05);非细菌感染组的Hs-CRP的水平显著高于健康对照组(P<0.05),但WBC、中性粒细胞百分比与健康对照组差异无统计学意义(P>0.05);Hs-CRP在诊断上呼吸道感染的特异性显著高于WBC和中性粒细胞比率(P<0.05);细菌感染组中Hs-CRP灵敏度均显著高于WBC及中性粒细胞比率(P<0.05);细菌感染组患者Hs-CRP、WBC及中性粒细胞比值水平均随着治疗显著下降,但Hs-CRP下降更为明显。结论:超敏C-反应蛋白联合、白细胞计数及中性粒细胞比值在诊断儿童呼吸道感染中具有快速、敏感、高效的特点,且优于单一检测,临床可广泛应用。

Objective:To investigate the diagnostic value of high sensitivity C-reactive protein, white blood cell count and neutrophil ratio in children with respiratory tract infection. Methods: The study systematically reviewed 100 children with respiratory infection in a hospital from October, 2015 to March, 2018. They were divided into the bacterial infection group and the no bacterial infection group according to the types of infection pathogens, and 50 children in each group. In the same period, 50 healthy children were enrolled in a healthy control group. All children enrolled in the study were tested for venous blood in the early morning to detect high sensitivity C-reactive protein and blood routine, and to determine the Hs-CRP, white blood cell count, neutrophil ratio. The sensitivity and specificity of Hs-CRP, WBC and neutrophils in the diagnosis of upper respiratory tract infection were compared. Results: The Hs-CRP level, the ratio of WBC to neutrophils in the bacterial infection group were significantly higher than those of the non bacteria group and the healthy control group(P<0.05). The level of Hs-CRP in the non bacterial infection group was significantly higher than that in the healthy control group(P<0.05). However, the percentage of WBC and neutrophils was not significantly different from that of healthy controls(P>0.05). The specificity of Hs-CRP in the diagnosis of upper respiratory tract infection was significantly higher than that of WBC and neutrophil(P<0.05). In bacterial infection group, the Hs-CRP sensitivity was significantly higher than that of WBC and neutrophil(P<0.05), and the Hs-CRP, WBC and neutrophil ratio of patients in bacterial infection group decreased significantly with the treatment, but the Hs-CRP decreased more significantly. Conclusion: Hs-CRP, WBC count and neutrophil ratio is rapid, sensitive and efficient in the diagnosis of respiratory tract infection in children. It is superior to single detection and can be widely used in clinical practice.