血常规和CRP联合检测对于急性发热患儿的临床价值分析

Analysis of Clinical Value of combined Blood Routine Examination and CRP in Children with Acute Fever

目的研究血常规和CRP联合检测对于急性发热患儿的临床价值。方法回溯性分析本院于2021年1~12月收治的61168例急性发热患儿,其中感染患者60例纳入观察组,选取同期健康体检儿童60例作为对照组,急性发热患儿和健康体检儿童均采用全自动血液细胞分析仪进行血常规和CRP联合检测,对比急性发热患儿和健康体检儿童的白细胞计数和CRP指标检测结果,并对急性发热患儿各感染类型诊断结果、各感染类型的白细胞计数和CRP指标检测结果、阳性表达情况以及诊断方法进行评估。结果观察组急性发热患儿白细胞计数、C反应蛋白检测结果高于对照组,有统计学意义(t=9.126、9.403,P<0.05)。细菌感染患儿白细胞计数、C反应蛋白检测结果高于支原体感染患儿、病毒感染患儿,而且支原体感染患儿白细胞计数、C反应蛋白检测结果高于病毒感染患儿,各感染类型的白细胞计数和CRP指标检测结果对比有统计学意义。观察组急性发热患儿阳性表达情况中:细菌感染患儿白细胞计数检测、C反应蛋白检测、二者联合检测的阳性表达率分别为77.27%(17/22)、72.73%(16/22)、95.45%(21/22),血常规和CRP联合检测阳性表达率高于白细胞计数检测、C反应蛋白检测,有统计学意义(χ^(2)=16.640,P<0.05);病毒感染患儿白细胞计数检测、C反应蛋白检测、二者联合检测的阳性表达率分别为53.33%(16/30)、56.67%(17/30)、93.33%(28/30),血常规和CRP联合检测阳性表达率高于白细胞计数检测、C反应蛋白检测,有统计学意义(χ^(2)=13.988,P<0.05);支原体感染患儿白细胞计数检测、C反应蛋白检测、二者联合检测的阳性表达率分别为62.50%(5/8)、62.50%(5/8)、87.50%(7/8),血常规和CRP联合检测阳性表达率高于白细胞计数检测、C反应蛋白检测,有统计学意义(χ^(2)=18.261,P<0.05)。白细胞计数、C反应蛋白二者联合检测预测界值、AUC(曲线下面积)、95%CI分别为18.70、0.942、98.1~89.0,血常规和CRP联合检测的预测界值、AUC(曲线下面积)、95%CI均高于白细胞计数检测、C反应蛋白检测。结论血常规和CRP联合检测对于急性发热患儿的临床价值优于血常规或CRP单独检测,虽然急性发热患儿与健康体检儿童相比白细胞计数和CRP指标均呈显著升高趋势,但是细菌感染、病毒感染、支原体感染的急性发热患儿白细胞计数和CRP指标存在显著差异,因此血常规和CRP联合检测下急性发热患儿的诊断准确率更高,血常规和CRP联合检测在急性发热患儿感染类型诊断中更具推广价值。

Objective To study the clinical value of combined detection of blood routine examination and CRP in children with acute fever.Methods Retrospective analysis was made on 61168 children with acute fever admitted in our hospital from January 2021 to December 2021,of which 60 patients with infection were included in the observation group,60 children with health examination at the same time were selected as the control group,and both groups of children with acute fever and children with health examination were tested by automatic blood cell analyzer for blood routine examination and CRP,The white blood cell count and CRP index test results of the two groups of children with acute fever and healthy children were compared,and the diagnostic results of each type of infection,white blood cell count and CRP index test results of each type of infection,positive expression and diagnostic methods of children with acute fever were evaluated.Results The white blood cell count and C-reactive protein in the observation group were significantly higher than those in the control group(t=9.126,9.403,P<0.05).The white blood cell count and C-reactive protein test results of children with bacterial infection were higher than those of children with mycoplasma infection and virus infection,and the white blood cell count and C-reactive protein test results of children with mycoplasma infection were higher than those of children with virus infection.The white blood cell count and CRP index test results of various infection types were statistically significant.In the positive expression of children with acute fever in the observation group,the positive expression rates of leukocyte count test,C-reactive protein test and combined test of the two in children with bacterial infection were 77.27%(17/22),72.73%(16/22)and 95.45%(21/22)respectively.The positive rate of the combined test of blood routine test and CRP was higher than that of leukocyte count test and C-reactive protein test,with statistical significance(χ^(2)=16.640,P<0.05);The positive expression rates of leukocyte count test,C-reactive protein test and their combined tests in children with viral infection were 53.33%(16/30),56.67%(17/30)and 93.33%(28/30)respectively.The positive expression rates of blood routine test and CRP combined test were higher than those of leukocyte count test and C-reactive protein test,with statistical significance(χ^(2)=18.261,P<0.05);The positive expression rates of leukocyte count test,C-reactive protein test and their combined tests in children with mycoplasma infection were 62.50%(5/8),62.50%(5/8)and 87.50%(7/8),respectively.The positive expression rates of blood routine test and CRP combined test were higher than those of leukocyte count test and C-reactive protein test,with statistical significance(χ^(2)=13.988,P<0.05).The predictive threshold,AUC(area under the curve),and 95%CI of the combined detection of leukocyte count and C-reactive protein were 18.70,0.942,98.1-89.0,respectively.The predictive threshold,AUC(area under the curve),and 95%CI of the combined detection of blood routine examination and CRP were higher than those of leukocyte count detection and C-reactive egg white detection.Conclusion The clinical value of combined blood routine examination and CRP examination for children with acute fever is better than that of blood routine examination or CRP examination alone.Although the leukocyte count and CRP index of children with acute fever are significantly higher than those of healthy children,the leukocyte count and CRP index of children with acute fever with bacterial infection,viral infection and mycoplasma infection are significantly different,Therefore,the diagnostic accuracy of children with acute fever is higher under the combined detection of blood routine examination and CRP,and the combined detection of blood routine examination and CRP has more promotion value in the diagnosis of infection type of children with acute fever.