血清CRP、ESR、LDH、SF对病因待查发热患儿的诊断效果

Serum CRP, ESR, LDH, SF the diagnosis of the cause of unknown origin fever in children

目的 :探讨血清C-反应蛋白(C-reactive protein,CRP)、红细胞沉降率(Erythrocyte sedimentation rate,ESR)、乳酸脱氢酶(Lactate dehydrogenase,LDH)、血清铁蛋白(Ferritin,SF)对病因待查发热患儿的诊断效果。方法 :选取2015年2月~2016年7月我院收治的病因待查发热患儿32例,依据出院诊断分为感染性(15例)、肿瘤性(5例)和风湿免疫性(12例),比较三组患儿的CRP、ESR、LDH、SF水平,并进行ROC曲线分析。结果 :感染性、肿瘤性、风湿免疫性患儿的CRP依次升高,肿瘤性患儿的LDH高于风湿免疫性患儿,风湿免疫性患儿的LDH又高于感染性患儿。三组患儿的ESR、SF无显著差异。CRP对感染性、肿瘤性和风湿免疫性发热的诊断效果较好,LDH对感染性和肿瘤性发热的诊断效果较好,但对风湿免疫性发热的诊断效果不佳。ESR、SF对感染性、肿瘤性和风湿免疫性发热均不具有明显的诊断价值。CRP+ESR+LDH+SF4项指标联合诊断感染性、肿瘤性及风湿免疫性发热的灵敏度分别为76.25%、80.35%、94.63%,特异度分别为60.21%、65.28%、80.22%,均具有良好的诊断效果。结论 :血清CRP、ESR、LDH、SF联合对病因待查发热患儿具有良好的诊断效果,其中血清CRP和LDH单独检测仍具有一定的临床参考价值。

Objective To investigate the serum CRP、ESR、LDH、SF on the cause of fever of unknown origin in children with the diagnosis.Methods Selected February 2015 to July2016 in our hospital 32 cases the cause of children with fever of unknown origin, according to the discharge diagnosis divided into infectious (15 cases), tumor (5 cases) and rheumatic autoim-mune (12 cases), comparison of the three groups of children with CRP, ESR, LDH, SF levels and ROC curve analysis.Results Infectious, neoplastic, rheumatic autoimmune children with elevated CRP in turn, LDH tumors in children is higher than that of children with rheumatic autoimmune, LDH was higher than children with rheumatic autoimmune infection in children. ESR three children, SF no significant difference. CRP to infection, the diagnosis of neoplastic and autoimmune rheumatic fever is better, LDH infectious and neoplastic fever diagnosis is better, but poor for the diagnosis of rheumatic fever immunity. ESR, SF of infection, cancer and autoimmune rheumatic fever are not having a significant diagnostic value. The sensitivity of CRP + ESR + LDH + SF4 were 76.25%,80.35% and 94.63% respectively, and the specificity was 60.21%,65.28% and 80.22%, respec-tively. All of them had a good correlation with the diagnosis of infectious, neoplastic and rheumatic fever. Of the diagnostic ef-fect.Conclusions Serum CRP, ESR, LDH, SF in children with fever to be diagnosed have a good diagnostic effect, serum CRP and LDH alone test still has some clinical reference value.