降钙素原联合CD64指数对小儿肺部感染的诊断价值分析

Analysis on the diagnostic value of procalcitonin combined with CD64 index in children with pulmonary infection

目的探讨降钙素原(PCT)联合CD64指数对小儿肺部感染的诊断价值。方法选取2018年6月—2019年3月长治市人民医院儿科收治的肺部感染患儿100例作为研究对象,通过血培养、痰培养等检查结果确诊52例细菌感染患儿为Bacteria组,27例病毒感染患儿为Viruses组,21例支原体感染患儿为Mycoplasma组;另外选取该院呼吸系统健康儿童40例作为Blank组。通过指标检测和阳性检测判定标准对各组血浆检测指标情况和阳性率等情况进行对比分析。结果Bacteria组PCT、白细胞计数(WBC)及C-反应蛋白(CRP)值显著高于Mycoplasma组、Viruses组和Blank组(均P<0.05),Mycoplasma组中的PCT、WBC及CRP值明显高于Viruses组和Blank组(均P<0.05),Viruses组中的PCT、WBC及CRP值高于Blank组(P<0.05);Bacteria组中的CD64指数明显高于Mycoplasma组、Viruses组及Blank组(均P<0.05);PCT曲线下面积(0.865)>CD64(0.842)>CRP(0.781)>WBC(0.769),与标准面积0.5相比,差异有统计学意义(均P<0.05);当PCT≥0.19 ng/ml时,灵敏度为90.38%,特异度为82.69%;当CD64≥2.56时,灵敏度为88.46%,特异度为86.54%;当WBC≥10×10^(9)/L时,灵敏度为80.77%,特异度为76.92%;当CRP≥10.35 mg/L时,灵敏度为76.92%,特异度为86.54%;Bacteria组PCT、WBC及CRP阳性率显著高于Mycoplasma组、Viruses组及Blank组(均P<0.05),Mycoplasma组PCT、WBC及CRP阳性率明显高于Viruses组和Blank组(均P<0.05),Viruses组PCT、WBC及CRP阳性率高于Blank组(P<0.05)。结论PCT联合CD64可以作为小儿肺部感染诊断的主要指标,在临床实际工作中PCT联合CD64及其他辅助性的指标对小儿肺部感染进行综合评估,对临床的治疗具有非常重要的意义。

Objective To investigate the diagnostic value and clinical research analysis of procalcitonin(PCT)combined with CD64 index in children with pulmonary infection.Methods A total of 100 children with pulmonary infection were selected into the research.52 children with bacterial infection were confirmed by blood culture,sputum culture and other examination results were selected as the Bacteria group,27 children with viral infection were in the Viruses group,and 21 children with mycoplasma infection were in the Mycoplasma group.40 healthy children were selected as the Blank group.The plasma detection index and positive rate of each group were compared and analyzed through index detection and positive detection criteria.Results The PCT,white blood cell count(WBC)and C-reactive protein(CRP)in the Bacteria group were significantly higher than those in the Mycoplasma group,Viruses group and Blank group(all P<0.05).The PCT,WBC and CRP in the Mycoplasma group were significantly higher than those in the Viruses and Blank groups(all P<0.05).The PCT,WBC and CRP in the Viruses group were higher than those in the Blank group(P<0.05).The CD64 index in the Bacteria group was significantly higher than that in the Mycoplasma group,Viruses group and Blank group(all P<0.05).The order of the area under the curve was PCT(0.865)>CD64(0.842)>CRP(0.781)>WBC(0.769),which was significantly different from the standard area of 0.5(all P<0.05).As PCT≥0.19 ng/ml,the diagnostic sensitivity was 90.38%,diagnostic specificity was 82.69%.As CD64≥2.56,the diagnostic sensitivity was 88.46%,specificity was 86.54%.As WBC≥10×10^(9)/L,the diagnostic sensitivity was 80.77%,diagnostic specificity was 76.92%.As CRP≥10.35 mg/L,the diagnostic sensitivity was 76.92%and the specificity was 86.54%.The positive rates of PCT,WBC and CRP in the Bacteria group were significantly higher than those in the Mycoplasma group,Viruses group and Blank group(all P<0.05).The positive rates of PCT,WBC and CRP in the Viruses group were significantly higher than those in the Viruses group and Blank group(all P<0.05).Conclusion PCT combined with CD64 index can be used as the diagnostic tool for pulmonary infection in children.PCT combined with CD64 index and other auxiliary indicators,such as WBC and CRP,can comprehensively evaluate children with pulmonary infection,which is very important for clinical treatment.