本文選題：C-反應(yīng)蛋白 + 降鈣素原　； 參考：《中華醫(yī)院感染學(xué)雜志》2016年20期

【摘要】：目的研究?jī)和毙园l(fā)熱無(wú)明顯感染灶運(yùn)用常用檢驗(yàn)指標(biāo)進(jìn)行診斷的臨床價(jià)值,為臨床診斷提供理論依據(jù)。方法選擇2013年5月-2015年5月醫(yī)院診治456例未見(jiàn)明顯感染灶以及病態(tài)的急性發(fā)熱住院患兒臨床資料,根據(jù)最終診斷研究C-反應(yīng)蛋白(CRP)、血白細(xì)胞計(jì)數(shù)(WBC)、降鈣素原(PCT)及中性粒細(xì)胞百分比的診斷價(jià)值。結(jié)果 456例患兒中84例患有嚴(yán)重疾病,其PCT和CRP水平均比非嚴(yán)重疾病患兒高,差異有統(tǒng)計(jì)學(xué)意義(P0.01);CRP診斷截點(diǎn)為67.1mg/L時(shí),對(duì)嚴(yán)重疾病診斷的靈敏度為0.810,特異度為0.715;PCT診斷截點(diǎn)為0.505μg/L,靈敏度為0.762,特異度為0.672;聯(lián)合兩者的特異度達(dá)到了0.918,靈敏度為0.617;64例患兒為病毒感染,80例患兒為細(xì)菌感染,30例患兒為支原體屬感染,根據(jù)感染類(lèi)型不同,患兒之間CRP、PCT、WBC及中性粒細(xì)胞百分比的差異有統(tǒng)計(jì)學(xué)意義(P0.01);當(dāng)對(duì)細(xì)菌和病毒感染進(jìn)行鑒別時(shí),對(duì)于CRP診斷截點(diǎn)為38mg/L,靈敏度為0.900,特異度為0.813;PCT診斷截點(diǎn)為0.450μg/L,靈敏度為0.700,特異度為0.812;假如兩者結(jié)合,特異度為0.965,敏感度為0.630,當(dāng)對(duì)支原體與細(xì)菌感染進(jìn)行鑒別時(shí),CRP的診斷截點(diǎn)為80.75mg/L,靈敏度為0.700,特異度為0.933。結(jié)論對(duì)于無(wú)明顯感染灶及病態(tài)的急性發(fā)熱患兒,運(yùn)用CRP及PCT鑒別5歲患兒病情的嚴(yán)重度及病原學(xué)具有一定的幫助,而且兩者聯(lián)合應(yīng)用的特異性更佳。
[Abstract]:Objective to study the clinical value of using common test indexes in the diagnosis of children with acute fever without obvious infection, and to provide theoretical basis for clinical diagnosis. Methods from May 2013 to May 2015, 456 hospitalized children with acute fever without obvious infection and pathological conditions were selected. According to the final diagnosis, the diagnostic value of C-reactive protein (CRP), white blood cell count (WBC), procalcitonin (PCT) and percentage of neutrophils were studied. Results the levels of PCT and CRP in 84 of 456 children with severe disease were higher than those with non-severe disease. The difference was statistically significant when the diagnostic cut-off point of 67.1mg/L was 67.1mg/L. The sensitivity for the diagnosis of severe diseases was 0.810, the specificity was 0.715 渭 g / L, the sensitivity was 0.762and the specificity was 0.672.The specificity of the combination was 0.918, and the sensitivity was 0.6171.64 cases of viral infection and 80 cases of bacterial infection were 30 cases. The children were infected with Mycoplasma. According to the type of infection, there were significant differences in the percentage of WBC and neutrophils between the children with CRP, PCT, WBC and neutrophils, and when the bacterial and viral infections were differentiated, there was a significant difference in the percentage of WBC and neutrophils. For CRP, the diagnostic cut-off point is 38 mg / L, the sensitivity is 0.900, the specificity is 0.813, the diagnostic cut-off point is 0.450 渭 g / L, the sensitivity is 0.700, and the specificity is 0.812. The specificity was 0.965 and the sensitivity was 0.630.The diagnostic cut-off point of CRP was 80.75 mg / L, the sensitivity was 0.700 and the specificity was 0.933 when the mycoplasma and bacterial infections were differentiated. Conclusion CRP and PCT can be used to identify the severity and etiology of 5-year-old children with acute fever without obvious infective foci and morbid conditions, and the specificity of the combined use of the two methods is better.
【作者單位】： 濟(jì)南市第四人民醫(yī)院檢驗(yàn)科;
【基金】：山東省衛(wèi)生廳科研基金資助項(xiàng)目(SW2010B-028)
【分類(lèi)號(hào)】：R446

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