儿童感染性疾病中降钙素原、超敏C-反应蛋白和白细胞联合检测的价值及相关性研究

目的 探讨儿童感染性疾病中降钙素原（PCT）、超敏C-反应蛋白（Hs-CRP）、白细胞计数（WBC）的变化及其临床意义.方法 选取2011年7月-2013年12月期间住院的122例患儿（细菌性感染67例,病毒性感染55例）,检测所有患儿PCT,hs-CRP和WBC的浓度水平,并在细菌感染组、病毒感染组、对照组进行分析比较.结果 ①治疗前细菌感染组PCT,hs-CRP和WBC分别为7.26±2.24 ng/ml,15.45±8.37 mg/L和（13.57±2.39）×109/L;病毒感染组分别为0.91±0.56 ng/ml,5.27±3.85 mg/L和（9.79±3.65）×109/L;对照组分别为0.76±0.45 ng/ml,2.45±1.35 mg/L和（6.77±2.35）×109/L;治疗后细菌感染组分别为1.15±0.86 ng/ml,6.21±3.57 mg/L和（9.35±4.56）×109/L;病毒感染组分别为0.64±0.48 ng/ml,3.68±2.94 mg/L和（8.48±4.73）×109/L.治疗前三组间PCT,hs-CRP和WBC差异均有统计学意义（F=12.34-16.56,P均＜0.01）,细菌感染组PCT与hs-CRP,WBC差异均有统计学意义（t=4.43,5.83,P均＜0.01）.细菌感染组PCT,hs-CRP,WBC治疗前后相比差异均有统计学意义（t=3.34-7.23,P均＜0.01）,但病毒感染组治疗后PCT,hs-CRP,WBC较治疗前有所下降,但差异均无统计学意义（t=2.57-4.21,P均＞0.05）.②在细菌感染组中PCT,hs-CRP和WBC阳性率之间差异有统计学意义（f=8.81,P＜0.05）,局部与严重细菌感染组中PCT阳性率的差异有统计学意义（χ^2=5.91,P＜0.05）;hs-CRP,WBC阳性率在两组间差异无统计学意义（χ^2=0.86,0.85,P均＞0.05）,且局部细菌感染组中PCT,hs-CRP,WBC阳性率之间差异有统计学意义（χ^2=2.45,P＞0.05）,严重细菌感染组PCT,hs-CRP和WBC阳性率之间差异均有统计学显著性意义（χ^2=8.57,P＜0.05）,且PCT与hs-CRP,WBC的阳性率之间差异均有统计学显著性意义（χ^2=5.37,9.00,P＜0.05,0.01）.③对于诊断细菌感染以0.5 ng/ml为临界值,PCT的灵敏度为92.5％,特异度为80.6％,阳性预测值为81.5％,阴性预测值为92.6％;以2 ng/ml为临界值,灵敏度为55.2?

Role and Correlation of Procalcitonin,Hypersensitive C-reactive Protein and White Blood Cell Count in Children Infection Diseases

Objective To study the clinical value of procalcitonin （PCT）,hypersensitive C-reactive protein （hs-CRP） and white blood cell count （WBC） in the infection diseases in children.Methods From July 2011 to December 2013,122 hospitalized children who were 55 children with bacterial infection and 67 children with viral infection were detected for PCT,hs CRP,WBC concentrations that were for analysis in the bacterial infection group,viral infection group and the control group carries.Results ①Before treatment the levels of PCT,hs-CRP,WBC were respectively 7.26 ± 2.24 ng/ml,15.45 ± 8.37 mg/L and （13.57± 2.39）× 109/L respectively in the bacterial infection group; 0.91 ± 0.56 ng/ml,5.27 ± 3.85 mg/L and （9.79±3.65） ×109/L respectively in the virus infection group;0.76±0.45 ng/ml,2.45±1.35 mg/L and （6.77±2.35）× 109/L respectively in the control group.After treatment the levels of PCT,hs-CRP and WBC were respectively 1.15 ± 0.86ng/ml,6.21 ±3.57 mg/L and （9.35±4.56）× 109/L respectively in the bacterial infection group;0.64±0.48 ng/ml,3.68±2.94 mg/L and （8.48±4.73）× 109/L respectively in the virus infection group.Before treatment in the three groups the levels of PCT,hs-CRP and WBC were statistically significant （F=12.34-16.56,P〈0.01）.The levels of PCT,hs-CRP and WBC were statistically significant （t=4.43,5.83,P〈0.01） in the bacterial infection group before treatment.In the bacterial infection group the levels of PCT,hs-CRP and WBC before treatment were statistically significant compared to that after treatment （t=3.34- 7.23,P〈 0.01）,but no statistically significant in the virus infection group （t=2.57 - 4.21,P〉0.05）.②In the bacterial infections group,there were statistically significant in the positive rates of PCT,hs-CRP and WBC （χ^2=8.81,P〈0.05）.The positive rates of PCT were statistically significant between local and severe bacterial infection group （χ^2=5.91,P〈0.05）.The positive rates of hs-CRP and WBC were no statistically signifi