血清降钙素原及IL-6、IL-8在急性胃肠炎患儿中的检测意义

目的探讨血清降钙素原(procalcitonin,PCT)、白细胞介素6(IL-6)、白细胞介素8(IL-8)检测在急性胃肠炎患儿病原体鉴别中的临床意义。方法选择确诊的细菌性胃肠炎患儿35例(细菌组)、轮状病毒性胃肠炎患儿36例(病毒组)、健康儿童35例(对照组),分别检测3组儿童的血清PCT、IL-6、IL-8水平。结果细菌组血清PCT、IL-6水平显著高于病毒组及对照组(P0.05),且病毒组PCT、IL-6显著高于对照组(P0.05),细菌组IL-8水平显著高于对照组(P0.05),但细菌组与病毒组比较,IL-8水平无显著性差异(P0.05);PCT与IL-6诊断细菌性胃肠炎的敏感度分别为71.4%、65.7%(P0.05),特异度分别为72.2%、66.7%(P0.05),均显著高于IL-8(P0.05)。PCT+IL-6检测对细菌性急性胃肠炎诊断的敏感度94.3%,特异度94.4%,均显著高于单独检测PCT或IL-6(P0.05)。结论血清PCT对早期小儿细菌性与病毒性胃肠炎感染的鉴别诊断具有重要意义,而PCT与IL-6联合检测准确性更高。

Significance of serum procalcitonin,interleukin 6 and interleukin 8 detection in children with acute gastroenteritis

Objective To investigate the clinical significance of serum procalcitonin （PCT）,IL-6 and IL-8 levels in identification of pathogens in children with acute gastroenteritis.Methods Serum PCT,IL-6 and IL-8 were detected in 35 patients with bacterial gastroentrtitis （bacterial group）,36 patients with viral gastroenteritis （viral group） and 35 healthy children （control group）.Results Serum PCT and IL-6 in bacterial group were significant higher than those in viral and control groups （P ＜ 0.05）,and they were significantly higher in the viral group than those in the control group （P ＜ 0.05） ; IL-8 was significantly higher in viral group and bacterial group than that in the control group （P ＜ 0.05）,but there was no significant difference between the bacereial group and the viral group （P ＞ 0.05）.The sensitivity in diagnosing of bacterial gastroentrtitis of PCT and IL-6 were 71.4％ and 65.7％ （P ＞ 0.05）,and specificities were 72.2％ and 66.7％ （P ＞0.05）,significantly higher than IL-8 （P ＜0.05） ; the sensitivity of PCT ＋ IL-6 was 94.3％,and the specificity was 94.4％,significantly higher than detecting PCT or IL-6 alone （P ＜ 0.05）.Conclusion Serum PCT has important significance in the differential diagnosis of viral and bacterial gastroenteritis,and the combination of PCT and IL-6 has a higher accuracy.