贵州医科大学学报

2013, v.38;No.165(06) 635-637

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PCT、CRP、WBC联合检测对儿童早期细菌感染的诊断价值
The Combined Diagnostic Value of Serum Procalcitonin,C-reactive Protein and White Blood Cell Count for the Early Stage of Bacterial Infection in Childhood

黄平;张振洪;龙喜雄;
HUANG Ping;ZHANG Zhenhong;LONG Xixiong;Department of Clinical Laboratory,the Second People's Hospital of Nanhai District of Foshan City;

摘要(Abstract):

目的:探讨血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)3种指标联合检测对儿童早期细菌感染的诊断价值。方法:将受试者分为重症细菌感染组(A组)、局部细菌感染组(B组)、病毒感染组(C组)和健康体检组(D组);静脉采血测定PCT、CRP、WBC,并比较4组3种指标水平,分析这些指标的诊断敏感性及特异性。结果:A组PCT和CRP明显高于B、C、D组(P<0.05),B组PCT和CRP高于C、D组(P<0.05),A组WBC与C、D组差异有统计学意义(P<0.05),与B组比较无统计学意义(P>0.05);以PCT>0.5μg/L为阈值,诊断重症感染的敏感性为100%,为3种指标中最高;以CRP>10 mg/L为阈值,诊断局部感染的敏感性为85.7%,为3种指标中最高。结论:PCT对重症细菌感染的诊断价值高,对局部细菌感染敏感性不如CRP,WBC对感染的诊断亦有一定的作用。
Objective: To explore the combined diagnostic value of serum procalcitonin( PCT),Creactive protein( CRP) and white blood cell( WBC) count for early stage of bacterial infection in childhood. Methods: Totally 438 children were included and divided into four groups: severe bacterial infection group( group A,79 cases),mild bacterial infection group( group B,126 cases),virus infection group( group C,163 cases) and healthy control group( group D,70 cases). The levels of PCT,CRP and WBC were evaluated in the venous blood samples. Results: The PCT and CRP levels in groups A and B were significantly higher than those of groups C and D and were highest in group A.In addition,the WBC counts were also higher in groups A and B those that of groups C and D. But we couldn't identify significant difference in WBC counts between group A and group B. The sensitivity of PCT for the diagnosis of severe bacterial infection was significantly higher than CRP and WBC. And using PCT > 0. 5 μg / L as cut-point,100% sensitivity for diagnosis could be achieved. In children with mild bacterial infection,using CRP > 10 mg / L as cut-point could achieve 85. 7% diagnosis sensitivity,which was significant higher than the other two parameters. Conclusion: PCT is a highly efficient laboratory parameter for the diagnosis of severe bacterial infection in childhood while CRP is more sensitive in mild bacterial infection. WBC counts are less efficient than PCT and CRP for the diagnosis of bacterial infection but have the advantages of lower cost.

关键词(KeyWords): 降钙素原;C反应蛋白;白细胞计数;细菌感染;儿童;诊断
procalcitonin;C reactive protein;luekocyte count;bacterial infections;child;diagnosis

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基金项目(Foundation): 佛山市卫生局科研资助项目(2012241)

作者(Author): 黄平;张振洪;龙喜雄;
HUANG Ping;ZHANG Zhenhong;LONG Xixiong;Department of Clinical Laboratory,the Second People's Hospital of Nanhai District of Foshan City;

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