降钙素原在手足口病合并细菌感染患儿中的早期临床诊断作用

目的探讨血清降钙素原（PCT）水平对手足口病合并细菌感染患儿早期鉴别诊断的意义。方法回顾性分析2012年1-7月某院住院的234例手足口病患儿病历资料，按照出院诊断结果分为单纯病毒感染组（178例）和合并细菌感染组（56例），同时选取20名健康儿童资料作为对照组，进行血清PCT、C反应蛋白（CRP）及外周血白细胞（WBC）计数的比较。结果各组血清PCT、CRP及外周血WBC水平的比较，差异均有统计学意义（F值分别为381.94、24.18和26.46，均P＜0.05）。各组血清PCT、CRP及外周血WBC水平的阳性检出率比较，差异均有统计学意义（χ2值分别为178.25、38.98和71.21，均P＜0.05），其中合并细菌感染组的血清PCT、CRP及外周血WBC水平阳性检出率［分别为92.86%（52/56）、85.71%（48/56）和87.50%（49/56）］明显高于单纯病毒感染组［分别为3.93%（7/178）、62.36%（111/178）和30.90%（55/178）］及健康对照组［分别为5.00%（1/20）、10.00%（2/20）和5.00%（1/20）］。PCT、CRP及外周血WBC的敏感度分别为92.86%、85.71%和87.50%，特异度分别为95.00%、90.00%和95.00%。结论PCT水平对于鉴别手足口病合并细菌感染具有重要价值，其准确率、敏感性优于CRP及WBC水平，能指导临床用药。

Role of procalcitonin in early diagnosis of hand, foot and mouth disease with bacterial infection

ObjectiveTo evaluate the role of procalcitonin (PCT)in the early diagnosis for hand, foot and mouth disease (HFMD) with bacterial infection.MethodsClinical data of 234 HFMD children who were hospitalized  between January and July 2012 were analyzed retrospectively, according to discharge diagnosis, data  were divided into simple viral infection group (n=178）and viral associated with bacterial infection group (n=56）,and data of 20 healthy children were selected as the control group. Serum PCT, C reactive protein (CRP) and peripheral white blood cell  (WBC) count were compared. ResultsThere was significant difference in the level of PCT, CRP and WBC among three groups (F=381.94,24.18,and 26.46，respectively,all P＜0.05）.The positive rate of PCT,CRP and WBC among three groups was significantly different（χ2=178.25,38.98, and 71.21，all P＜0.05）， PCT,CRP and WBC in bacterial infection group(92.86%［52/56］,85.71%［48/56］, and 87.50%［49/56］respectively) were significantly higher than those of simple viral infection group (3.93%［7/178］,62.36%［111/178］,and 30.90%［55/178］respectively) and healthy control group (5.00%［1/20］,10.00%［2/20］, and 5.00%［1/20］respectively). The sensitivity rate of PCT,CRP and WBC was 92.86%,85.71%, and 87.50% respectively，specificity rate was 95.00%,90.00%,and 95.00% respectively.ConclusionThe level of PCT has important value for the early diagnosis of HFMD with bacterial infection, and its accuracy rate and sensitivity are better than CRP and WBC levels.