X线膀胱逆行性造影与CRP和PCT的相关性及对小儿尿路感染的诊断价值

Correlation between X-ray retrograde cystography and CRP,PCT and the diagnostic value for children with urinary tract infection

目的分析X线膀胱逆行性造影与C-反应蛋白(CRP)、降钙素原(PCT)的相关性及对小儿尿路感染的诊断价值。方法选取2017年6月—2022年6月丽水市中心医院收治的138例疑似尿路感染患儿,其中确诊为尿路感染的75例患儿为研究组,另外63例患儿为对照组。对患儿进行X线膀胱逆行性造影检查,采用酶联免疫吸附法(ELISA)检测CRP、PCT水平,采用受试者工作特征(ROC)曲线分析X线膀胱逆行性造影、CRP、PCT对小儿尿路感染的诊断价值。结果75例尿路感染患儿中,X线膀胱逆行性造影检出55例,检出率为73.33%。上尿路感染检出率88.89%,下尿路感染检出率为58.97%,与下尿路感染相比,X线膀胱逆行性造影对上尿路感染的检出率较高,差异有统计学意义(χ^(2)=7.016,P<0.05)。对照组患儿CRP水平为(4.85±0.85)mg/L,PCT水平为(0.88±0.09)μg/L,研究组患儿CRP水平为(9.52±1.52)mg/L,PCT水平为(3.12±0.46)μg/L,与对照组患儿相比,研究组患儿CRP、PCT水平升高,差异均有统计学意义(均P<0.05)。上尿路感染患儿CRP水平为(11.05±3.52)mg/L,PCT水平为(4.23±0.69)μg/L,下尿路感染患儿CRP水平为(7.85±0.23)mg/L,PCT水平为(2.24±0.86)μg/L,与上尿路感染患儿相比,下尿路感染患儿CRP、PCT水平均降低,差异均有统计学意义(均P<0.05)。X线膀胱逆行性造影阴性与感染部位呈负相关(r=-0.526,P<0.05),X线膀胱逆行性造影阳性、CRP、PCT与感染部位呈正相关(r=0.762、0.669、0.584,均P<0.05)。X线膀胱逆行性造影阴性与CRP、PCT呈负相关(r=-0.965、-0.825,均P<0.05),X线膀胱逆行性造影阳性与CRP、PCT呈正相关(r=0.526、0.652,均P<0.05)。与X线膀胱逆行性造影、CRP、PCT单项检测相比,联合检测对小儿尿路感染的诊断价值较高。结论X线膀胱逆行性造影联合CRP、PCT可提高小儿尿路感染的诊断准确率,且X线膀胱逆行性造影与CRP、PCT存在相关性。

Objective To analyze the correlation between X-ray retrograde cystography and C-reactive protein(CRP),procalcitonin(PCT)and the diagnostic value for children with urinary tract infection.Methods From June 2017 to June 2022,138 children suspected of urinary tract infection were selected from Lishui Central Hospital,then they were divided into study group(75 children diagnosed as urinary tract infection)and control group(63 children without urinary tract infection).X-ray retrograde cystography was conducted,enzymelinked immunosorbent assay(ELISA)was used to detect the levels of CRP and PCT,receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of X-ray retrograde cystography,CRP,and PCT for urinary tract infection in children.Results Among 75 children with urinary tract infection,55 children were detected by X-ray retrograde cystography,the detection rate was 73.33%.The detection rates of upper urinary tract infection and lower urinary tract infection were 88.89%and 58.97%,respectively.The detection rate of upper urinary tract infection by X-ray retrograde cystography was higher than that of lower urinary tract infection(χ^(2)=7.016,P<0.05).The levels of CRP and PCT in control group were(4.85±0.85)mg/L and(0.88±0.09)μg/L,respectively,the levels of CRP and PCT in study group were(9.52±1.52)mg/L and(3.12±0.46)μg/L,respectively,the levels of CRP and PCT in study group were higher than those in control group(P<0.05).The levels of CRP and PCT in children with upper urinary tract infection were(11.05±3.52)mg/L and(4.23±0.69)μg/L,the levels of CRP and PCT in children with lower urinary tract infection were(7.85±0.23)mg/L and(2.24±0.86)μg/L,the levels of CRP and PCT in children with lower urinary tract infection were lower than those in children with upper urinary tract infection(P<0.05).Negative X-ray retrograde cystography was negatively correlated with infection site(r=-0.526,P<0.05),positive X-ray retrograde cystography,CRP,and PCT were positively correlated with infection site(r=0.762,0.669,0.584,P<0.05).Negative X-ray retrograde cystography was negatively correlated with CRP and PCT(r=-0.965,-0.825,P<0.05),positive X-ray retrograde cystography was positively correlated with CRP,PCT(r=0.526,0.652,P<0.05).Compared with single detection of X-ray retrograde cystography,CRP,and PCT,the combined detection had higher diagnostic value for pediatric urinary tract infection.Conclusion X-ray retrograde cystography combined with CRP and PCT can improve the diagnostic accuracy of urinary tract infection in children,there is a correlation between X-ray retrograde cystography and CRP,PCT.