血清降钙素原和超敏C反应蛋白检测对发热儿童早期鉴别诊断应用价值.docVIP

血清降钙素原和超敏C反应蛋白检测对发热儿童早期鉴别诊断应用价值 　　[摘要] 目的 探讨血清降钙素原（PCT）和超敏C反应蛋白（hs-CRP）检测对发热儿童早期病因学诊断的应用价值。 方法 选取2013年1～12月入住本院儿科的发热患儿132例，检测血清PCT和hs-CRP水平，并同时行病因学检查，根据最后出院诊断结果将所有患儿分为细菌感染组和非细菌感染组，评价PCT和hs-CRP对儿科发热疾病病原学早期鉴别诊断的价值。 结果 细菌感染组患儿的PCT和hs-CRP水平均显著高于非细菌感染组（P0.05）。PCT诊断细菌感染的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为84.8%、85.0%、92.8%、70.8%、84.8%；hs-CRP诊断细菌感染的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为91.3%、55.0%、82.4%、73.3%、80.3%；PCT与hs-CRP联合检测诊断细菌感染的敏感度、特异度、准确率分别为95.7%、92.5%、92.4%。 结论 在发热患儿中，PCT和hs-CRP水平升???有助于早期诊断细菌感染。PCT特异性要好于hs-CRP，hs-CRP敏感性要好于PCT，两者联合检测可提高发热患儿病因诊断的敏感度、特异度及准确率，有助于早期鉴别细菌感染性发热和非细菌感染性发热，对指导治疗有积极意义。 　　[关键词] 血清降钙素原；超敏C反应蛋白；发热；诊断价值 　　[中图分类号] R446.11 [文献标识码] A [文章编号] 1674-4721（2015）02（a）-0116-04 　　Application value of serum procalcitonin and high sensitivity C-reactive protein on early differential diagnosis in fever children 　　LUO Cheng-wu LI Shen-gen WU Cai-xia ZHOU Yu LIU Yi 　　Department of Pediatrics，People′s Hospital of Xiangxiang City in Hunan Province，Xiangxiang 411400，China 　　[Abstract] Objective To probe into the application value of serum procalcitonin（PCT）and high sensitivity C-reactive protein（hs-CRP）on etiological diagnosis at an early stage in fever children. Methods 132 children with fever admitted into our hospital from January 2013 to December 2013 were selected.Serum PCT and hs-CRP were tested，and etiological examination was carried out at the same time.According to the final results of discharge diagnosis，all patients were divided into bacterial infection group and non-bacterial infection group in order to evaluate the values of PCT and hs-CRP on etiological and differential diagnosis at an early stage in department of pediatrics. Results In the bacterial infection group，level of PCT and hs-CRP was both remarkably higher than that in the non-bacterial infection group respectively（P 　　[Key words] Serum procalcitonin；High sensitivity C-reactive protein；Fever；Diagnostic value 　　发热是儿科临床最常见的症状之一，也是儿科患儿就诊的重要原因，其中绝大部分是急性感染引起，如细菌、病毒、真菌、结核等，也有非感染因素引起，如肿瘤、自身免疫性疾病等。判断发热的病因是处理发热