儿童肺炎支原体肺炎感染指标的诊断价值

Diagnostic value of infection indexes in children with Mycoplasma pneumoniae pneumonia

目的 探讨WBC、C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)、降钙素原(PCT)在儿童肺炎支原体肺炎(MPP)诊治中的价值.方法 回顾性分析本院儿科确诊的154例住院患儿(MPP组),以临床症状结合影像学的诊断结果 作为诊断标准,并选择同期非肺部感染患儿51例,作为对照组.对2组间WBC、CRP、SAA、PCT 4项炎性标志物的检测结果进行分析.结果 MPP组中WBC、CRP、SAA、PCT检测结果均显著高于对照组,差异有统计学意义(P均<0.05).单项检测时,PCT诊断敏感度最高[85.71%(132/154)],CRP和SAA特异度高[96.08%(49/51)、96.08%(49/51)];2项联合检测时,WBC+PCT诊断敏感度最高[94.81%(146/154)],WBC+SAA和CRP+SAA诊断特异度最高[均为96.08%(49/51)];3项联合检测时,WBC+CRP+PCT和WBC+PCT+SAA诊断敏感度最高[均为96.10%(148/154)],WBC+CRP+SAA诊断特异度最高[92.16%(47/51)];CRP+SAA+PCT+WBC联合检测的诊断敏感度最高[98.70%(152/154)],但特异度较低[60.78%(31/51)].结论 儿童MPP时,在检测肺炎支原体抗体的同时,通过联合检测WBC、CRP、SAA、PCT 4项炎症标志物可有效提高临床的诊断效能.

Objective To investigate the value of white WBC,C-reactive protein(CRP),serum amyloid A(SAA),and procalcitonin(PCT)in the diagnosis and treatment of Mycoplasma pneumoniae pneumonia(MPP)in children.Methods A retrospective analysis was performed on 154 hospitalized pediatric patients(MPP group)diagnosed at our hospital.The diagnosis criteria were clinical symptoms combined with imaging results,and 51 children with non-pulmonary infection were selected as a control group.Four inflammatory markers including WBC,CRP,SAA,and PCT were analyzed.Results WBC,CRP,SAA,and PCT in the MPP group were significantly higher than those in the control group(P<0.05).When detecting using a single index,the sensitivity of PCT was the highest[85.71%(132/154)],and the specificities of CRP and SAA were relatively high[96.08%(49/51)and 96.08%(49/51),respectively.When detecting by combination of two indexes,the diagnostic sensitivity of WBC+PCT was the highest[94.81%(146/154)],and the diagnostic specificities of WBC+SAA and CRP+SAA were the highest[both 96.08%(49/51)].When detecting by combination of three indexes,WBC+CRP+PCT and WBC+PCT+SAA had the highest diagnostic sensitivities[96.10%(148/154)],and WBC+CRP+SAA had the highest diagnostic specificity[92.16%(47/51)].CRP+SAA+PCT+WBC had the highest diagnostic sensitivity[98.70(152/154)],but a lower specificity[60.78%(31/51)].Conclusion In children with MPP,the combined detection of WBC,CRP,SAA,and PCT can effectively improve the clinical diagnostic efficiency while detecting Mycoplasma pneumoniae antibody simultaneously.