降钙素原和C反应蛋白及白细胞计数联合检测在诊断儿童感染性肺炎的价值

The value of combined detection of procalcitonin, Creactive protein and leukocyte count in the diagnosis of infectious pneumonia in children

目的探讨降钙素原(PCT)、C反应蛋白(CRP)和白细胞计数(WBC)联合检测在诊断儿童感染性肺炎(NIP)的价值。方法选取本院2018年1月至2019年5月收治的新生儿感染性肺炎患儿180例,其中,未明确感染性质(其他)组71例,混合感染组56例,细菌感染组53例,另选取同期非感染疾病新生儿190名为对照组,比较各组PCT、CRP、WBC的变化及灵敏度、特异度。结果治疗前,其他组PCT、CRP、WBC计数与对照组比较差异无统计学意义,混合感染组、细菌感染组PCT、CRP、WBC计数与对照组比较均明显升高(P<0.05);治疗后,混合感染组、细菌感染组PCT、CRP、WBC计数均明显下降(P<0.05),其他组PCT、CRP与治疗前比较差异无统计学意义,WBC计数显著下降(P<0.05)。混合感染组、细菌感染组CRP阳性率高于对照组、其他组(P<0.05),4组WBC计数比较差异无统计学意义。混合感染组、细菌感染组联合检测阳性率高于对照组、其他组(P<0.05)。混合感染组、细菌感染组、其他组联合检测灵敏度分别为84.12%、91.37%、41.37%;特异度分别为70.77%、90.27%、72.39%。结论针对感染性肺炎患儿,采取降钙素原与C反应蛋白联合检测,意义重大,价值明显,能够为临床治疗、预后评价提供重要依据。

Objective To explore the value of combined detection of procalcitonin(PCT), C-reactive protein(CRP) and white blood cell count(WBC) in the diagnosis of infectious pneumonia(NIP) in children. Methods 180 cases of neonatal infectious pneumonia admitted in our hospital from January 2018 to May 2019 were selected. Among them, 71 cases were in the undetermined infectious nature(other) group, 56 cases in the mixed infectious group and 53 cases in the bacterial infectious group. Another 190 cases of non-infectious neonates in the same period were selected as the control group. The changes of PCT, CRP, WBC, sensitivity and specificity of the two groups were compared. Results Before treatment, PCT,CRP and WBC counts in other groups had no significant difference compared with the control group, PCT, CRP and WBC counts in mixed infection group and bacterial infection group increased significantly(P<0.05). After treatment, PCT, CRP and WBC counts in mixed infection group and bacterial infection group decreased significantly(P<0.05), PCT and CRP in other groups had no difference, WBC counts decreased significantly(P<0.05). The positive rate of CRP in mixed infection group and bacterial infection group was higher than that in control group and other groups(P<0.05). There was no significant difference in WBC count among the four groups. The positive rate of combined detection of mixed infection group and bacterial infection group was higher than that of control group and other groups(P<0.05). The sensitivity and specificity of combined detection were 84.12%, 91.37%, 41.37% and 70.77%, 90.27% and 72.39% respectively in mixed infection group, bacterial infection group and other groups.Conclusions For children with infectious pneumonia, the combined detection of procalcitonin and C-reactive protein is of great significance and significant value, which can provide important basis for clinical treatment and prognosis evaluation.