实验室指标WBC、ESR、CRP、PCT联合检测对小儿支气管肺炎的早期诊断效能

Early diagnostic efficiency of laboratory indicators WBC,ESR,CRP,PCT combined detection for bronchial pneumonia in children

目的:探讨入院时实验室指标白细胞计数(White blood cell count,WBC)、红细胞沉降率(Erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)、降钙素原(Procalcitonin,PCT)联合检测对小儿支气管肺炎的早期诊断效能。方法:选取2022年1月至2023年12月郏县人民医院诊治的99例支气管肺炎患儿作为肺炎组,另选取同期99例健康体检儿童作为健康对照组。比较两组入院时WBC、ESR、CRP、PCT水平,比较细菌感染与病毒感染支气管肺炎患儿入院时WBC、ESR、CRP、PCT水平,采用受试者工作特征曲线(Receiver operation characteristic curve,ROC)分析WBC、ESR、CRP、PCT联合检测早期诊断小儿支气管肺炎及鉴别诊断细菌/病毒感染小儿支气管肺炎的效能。结果:肺炎组入院时WBC、ESR、CRP、PCT水平高于健康对照组(P<0.05);细菌感染支气管肺炎患儿入院时WBC、ESR、CRP、PCT水平高于病毒感染患儿(P<0.05);入院时WBC、ESR、CRP、PCT水平联合早期诊断支气管肺炎患儿曲线下面积(Area under curve,AUC)、最佳敏感度分别为0.925、87.88%,均高于上述指标单独检测;入院时WBC、ESR、CRP、PCT水平联合检测鉴别诊断细菌/病毒感染小儿支气管肺炎的AUC、最佳敏感度分别为0.906、93.48%,均高于上述指标单独检测。结论:入院时WBC、ESR、CRP、PCT水平与小儿支气管肺炎关系密切,上述指标联合检测对早期诊断小儿支气管肺炎、鉴别诊断细菌/病毒感染具有较高的诊断效能,可作为早期鉴别诊断细菌/病毒感染小儿支气管肺炎的实验室指标。

Objective:To investigate the early diagnostic efficiency of laboratory indicators white blood cell count(WBC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),procalcitonin(PCT)combined detection at admission for children with bronchial pneumonia.Methods:A total of 99 children with bronchial pneumonia treated in the County People's Hospital from Jan.2022 to Dec.2023 were selected as pneumonia group,and 99 healthy children in the same period were selected as healthy control group.The levels of WBC,ESR,CRP and PCT at admission were compared between the two groups,and the levels of WBC,ESR,CRP and PCT at admission were compared between children with bacterial infection and viral infection.Receiver operating characteristic curve(ROC)was used to analyze the efficiency of WBC,ESR,CRP and PCT combined detection at admission in early diagnosis and differential diagnosis of bacterial/viral bronchial pneumonia in children.Results:The levels of WBC,ESR,CRP and PCT at admission in pneumonia group were higher than those in healthy control group(P<0.05).The levels of WBC,ESR,CRP and PCT at admission in children with bacterial infection bronchial pneumonia were higher than those in children with viral infection(P<0.05).The AUC and optimal sensitivity of WBC,ESR,CRP and PCT combined detection at admission for early diagnosis of bronchial pneumonia in children were 0.925 and 87.88%,respectively,which were higher than above indicators detected alone.The AUC and optimal sensitivity of WBC,ESR,CRP and PCT combined detection at admission for the differential diagnosis of bacterial/viral infection bronchial pneumonia in children were 0.906 and 93.48%,respectively,which were higher than the above indicators alone.Conclusion:The levels of WBC,ESR,CRP and PCT at admission are closely related to bronchial pneumonia in children.The combined detection of above indicators has high diagnostic efficacy for early diagnosis of bronchial pneumonia and differential diagnosis of bacterial/viral infection in children,and can be used as laboratory indexes for early differential diagnosis of bronchopenitis in children with bacterial/viral infection.