中性粒细胞CD64、PCT联合CRP诊断儿童脓毒血症的价值

The Value of Neutrophil CD64,PCT Combined with CRP in the Diagnosis of Sepsis in Children

目的探讨中性粒细胞CD64、降钙素原(PCT)和C-反应蛋白(CRP)联合检测在儿童脓毒血症早期诊断中的价值。方法选取2017年1月~2018年12月鄂尔多斯市中心医院儿科收治的55例脓毒血症患儿作为观察组,将同期的55例非感染性疾病患儿作为对照组。分别采用流式细胞术、电化学发光法、免疫透射比浊法检测两组患儿入院时中性粒细胞CD64水平、血清PCT浓度、CRP浓度,比较三种指标独立检测和联合检测诊断儿童脓毒血症的灵敏度、特异度、阳性预测值及阴性预测值;分析观察组治疗前后中性粒细胞CD64、CRP、PCT水平变化情况。结果入院时观察组中性粒细胞CD64、PCT及CRP水平均高于对照组,差异有统计学意义(P<0.05);三种指标联合检测诊断儿童脓毒血症的灵敏度、阳性预测值、阴性预测值及准确度最高,分别为85.02%、75.60%、93.21%、90.15%;治疗后观察组患儿中性粒细胞CD64、PCT和CRP水平均低于治疗前,差异有统计学意义(P<0.05)。结论中性粒细胞CD64、PCT及CRP联合检测能有效提高儿童脓毒血症早期诊断率,为临床治疗提供参考依据。

Objective To investigate the value of combined detection of neutrophil CD64,procalcitonin(PCT)and C-reactive protein(CRP)in the early diagnosis of sepsis in children.Methods A total of 55 children with sepsis admitted to the Department of Pediatrics,Ordos Central Hospital from January 2017 to December 2018 were enrolled as the observation group.55 children with non-infectious diseases were used as the control group.Flow cytometry,electrochemiluminescence,and immunoturbidimetric assay were used to detect neutrophil CD64 levels,serum PCT concentrations,and CRP concentrations in the two groups.Three independent indicators and combined detection were used to diagnose children's pus.The sensitivity,specificity,positive predictive value and negative predictive value of toxemia were analyzed.The changes of CD64,CRP and PCT levels in neutrophils before and after treatment were analyzed.Results The levels of CD64,PCT and CRP in the neutrophils were higher in the observation group than in the control group,the difference was statistically significant(P<0.05).The sensitivity,positive predictive value,negative predictive value and accuracy of the three indicators combined with detection of sepsis in children were the highest,85.02%,75.60%,93.21%,90.15%,respectively.The neutrophil CD64,PCT and CRP levels in the observation group were lower than those before treatment,the difference was statistically significant(P<0.05).Conclusion The combined detection of neutrophil CD64,PCT and CRP can effectively improve the early diagnosis rate of sepsis in children,and provide reference for clinical treatment.