血清降钙素原在门诊儿童感染性疾病诊断中的价值

Value of serum procalcitonin in diagnosis of infectious diseases in children at an outpatient department

摘要:

目的探讨血清降钙素原（PCT）检测在门诊就诊儿童感染性疾病诊断中的应用价值。方法采用半定量固相免疫法测定某院儿科门诊166例发热患儿（分为细菌感染组98例，非细菌感染组68例）及同期60例健康体检儿童（对照组）血清PCT水平，同时检测血常规及C反应蛋白(CRP)，对3组结果进行比较。结果细菌感染组PCT、CRP、白细胞（WBC）计数、中性粒细胞百分比阳性率分别为92.86%（98例）、88.78%（87例）、86.73%（85例）、81.63%（80例），显著高于非细菌感染组［分别为10.29%（7例）、27.94%（19例）、25.00%（17例）、26.47%（18例）］和对照组［分别为6.67%（4例）、5.00%（3例）、8.33%（5例）、11.67%（7例）］，差异均有统计学意义(P＜0.01)。细菌感染组血清PCT检测的敏感性(92.86%)、特异性(89.71%)、约登指数(82.56)均高于CRP（分别为88.78%、72.06%、60.84）、WBC计数（分别为86.73%、75.00%、42.30）、中性粒细胞百分比（分别为81.63%、73.53%、55.15）。结论PCT可以作为儿童门诊快速诊断早期细菌感染的一个指标，且相比其他炎症指标具有更好的敏感性与特异性。

Abstract:

ObjectiveTo evaluate the value of serum procalcitonin (PCT) in diagnosis of infectious diseases in children at an outpatient department.MethodsSerum PCT value of 166 children with fever (98 in bacterial infection group, 68 in nonbacterial infection group) and 60 healthy children (control group) were detected by semiquantitative solid phase immunoassay， and blood routine test and Creactive protein (CRP) were also detected simultaneously, results of three groups were compared.ResultsIn bacterial infection group, the positive rates of PCT,CRP,white blood cell (WBC)count, and percentage of neutrophils were 92.86%（98 cases）,88.78%（87 cases）,86.73%（85 cases）,and 81.63%（80 cases） respectively, which were significantly higher than those of nonbacterial infection group(10.29%［7 cases］,27.94%［19 cases］,25.00%［17 cases］, 26.47%［18 cases］)and control group(6.67%［4 cases］,5.00%［3 cases］,8.33%［5cases］, 11.67%［7cases］) respectively (P＜0.01). Sensitivity (92.86%), specificity (89.71%) and Youden’s index (82.56) of serum PCT detection of bacterial infection group were all higher than those of CRP（88.78%,72.06%,60.84 respectively）and WBC（86.73%,75.00% and 42.30 respectively） and percentage of neutrophil (81.63%,73.53% and 55.15 respectively）.ConclusionPCT can be used as an indicator of the rapid diagnosis of early bacterial infection in children, and is with better sensitivity and specificity than the other inflammatory markers.