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目的探讨血清降钙素原(PCT)、C反应蛋白(CRP)及血常规在危重患儿感染中预测中的临床诊断价值。方法选取2014年5月至2015年5月广东省东莞市人民医院儿科收治的80例危重感染患儿作为研究对象,根据病原体检测结果将其分为细菌感染组(A组)、肺炎支原体感染组(B组)和病毒感染组(C组),其例数分别为20例、30例、30例。所有研究对象在入院时均进行PCT、CRP及血常规测定,比较分析3组患儿PCT、CRP及WBC水平;并分析PCT、CRP及WBC诊断细胞情况。结果 A组患者的PCT、CRP及WBC水平均明显高于B组、C组,且B组患者CRP水平明显高于C组,差异均有统计学意义(均P<0.05);PCT诊断细菌感染的灵敏度、特异度、阳性预测值、阴性预测值、约登指数均明显高于CRP及WBC,阳性阈值明显低于CRP及WBC,差异均有统计学意义(均P<0.05)。结论血清PCT、CRP及WBC联合检测能有效指导鉴别儿童危重症疾病,在细菌诊断中有良好效果。
Objective To investigate the clinical diagnostic value of serum procalcitonin (PCT), C-reactive protein (CRP) and blood routine in the prediction of infection in critically ill children. Methods 80 cases of critically ill children admitted to the Department of Pediatrics, Dongguan City People’s Hospital of Guangdong Province from May 2014 to May 2015 were selected as research objects. According to the results of pathogen detection, they were divided into bacterial infection group (A group), Mycoplasma pneumoniae infection group (Group B) and virus infection group (group C), the number of cases were 20 cases, 30 cases and 30 cases respectively. All subjects underwent PCT, CRP and routine blood tests at admission. The levels of PCT, CRP and WBC in three groups were compared and analyzed. The diagnosis of PCT, CRP and WBC were analyzed. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in group B and C (P <0.05). The CRP level in group B was significantly higher than that in group C (all P <0.05) The sensitivity, specificity, positive predictive value, negative predictive value, Youden index were significantly higher than CRP and WBC, the positive threshold was significantly lower than CRP and WBC, the difference was statistically significant (P <0.05). Conclusion The combined detection of serum PCT, CRP and WBC can effectively guide the identification of critical illness in children and has good effect in the diagnosis of bacteria.