【摘要】：目的:探討咽拭子PCT在小兒呼吸道細(xì)菌感染性疾病中的應(yīng)用價(jià)值。方法:選取2016年1月至2016年12月期間在吉林大學(xué)第一醫(yī)院小兒呼吸一科病房住院的120例急性呼吸道感染患兒為研究對(duì)象,分為細(xì)菌感染組、病毒感染組、肺炎支原體感染感染組,每組各40例。對(duì)所有被選定患兒進(jìn)行咽拭子PCT水平檢測(cè),同時(shí)對(duì)血常規(guī)、CRP、血清PCT、九項(xiàng)呼吸道感染病原體Ig M抗體進(jìn)行測(cè)定。在住院期間給予相應(yīng)的規(guī)范化治療。治療好轉(zhuǎn)后復(fù)查上述異常指標(biāo)。并觀察患兒抗生素使用及住院時(shí)間。數(shù)據(jù)采用SPSS22.0統(tǒng)計(jì)軟件進(jìn)行分析,計(jì)量資料以均數(shù)標(biāo)準(zhǔn)差((?)±s)表示,數(shù)據(jù)為正態(tài)分布,組間比較采用t檢驗(yàn),分類計(jì)數(shù)資料以例數(shù)(百分比)表示,比較采用x~2檢驗(yàn)。兩兩比較采用卡方分割法,通過調(diào)整檢驗(yàn)水準(zhǔn)(α/比較次數(shù))減少一類誤差。相關(guān)分析采用Spearman相關(guān)檢驗(yàn)。檢驗(yàn)水準(zhǔn)α為0.05。結(jié)果:1.細(xì)菌感染組患兒咽拭子PCT、血清PCT的陽性檢出率最高,支原體感染組其次,病毒感染組最低,三者比較有統(tǒng)計(jì)學(xué)意義(P0.001),其中細(xì)菌感染組與肺炎支原體感染組、病毒感染組比較差異有統(tǒng)計(jì)學(xué)意義(P0.0167),而肺炎支原體感染組與病毒感染組比較差異有沒有統(tǒng)計(jì)學(xué)意義(P0.0167)。2.咽拭子PCT及血清PCT區(qū)分細(xì)菌和非細(xì)菌感染的敏感度分別為87.5%,62.5%;特異度分別為86.3%,91.3%。敏感度比較:咽拭子PCT敏感度高于血清PCT,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。特異度比較:咽拭子PCT的特異度與血清PCT一致,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3.細(xì)菌感染組患兒用抗生素前咽拭子PCT水平與抗生素使用及住院時(shí)間均呈顯著正相關(guān)(rs=0.800,0.785;P0.001)。4.細(xì)菌感染組患兒急性期咽拭子PCT陽性率明顯高于恢復(fù)期,差異有統(tǒng)計(jì)學(xué)意義(x~2=42.076,P0.001)。結(jié)論:1.當(dāng)呼吸道存在細(xì)菌感染時(shí),咽拭子PCT具備良好的敏感性及特異性,可能是一個(gè)判斷呼吸道細(xì)菌感染的指標(biāo)之一。2.咽拭子PCT水平能反應(yīng)細(xì)菌感染的嚴(yán)重程度及病情變化。
[Abstract]:Objective: to investigate the application value of pharyngeal swab PCT in children with respiratory tract bacterial infection. Methods: from January 2016 to December 2016, 120 children with acute respiratory infection (ARI) who were hospitalized in Department of Pediatric Respiratory, first Hospital of Jilin University were divided into bacterial infection group and viral infection group. Mycoplasma pneumoniae infection group, 40 cases in each group. The PCT level of throat swab was measured in all selected children, and the blood routine, Ig M antibody of nine respiratory tract infection pathogens in serum of CRP, were detected at the same time. The corresponding standardized treatment was given during the period of hospitalization. The above abnormal indexes were reviewed after treatment. The antibiotic use and hospitalization time were observed. The data were analyzed by SPSS22.0 statistical software. The measured data were expressed as mean standard deviation (?) 鹵s), the data were normal distribution, the comparison between groups was expressed by t test, and the classified count data was expressed as the number of cases (percentage). X2 test was used for comparison. The chi-square method is used in pairwise comparison to reduce a class of errors by adjusting the test level (偽 / comparison times). Correlation analysis was performed with Spearman correlation test. The test level is 0. 05. Results: 1. The positive rate of PCT in pharyngeal swab PCT, was the highest in bacterial infection group, followed by mycoplasma infection group and virus infection group. There were significant differences among the three groups (P0.001), among which bacterial infection group and mycoplasma pneumoniae infection group. There was significant difference in virus infection group (P0.0167), but there was no statistical difference between mycoplasma pneumoniae infection group and virus infection group (P0.0167). 2. The sensitivity of pharyngeal swab PCT and serum PCT to distinguish bacterial infection from non-bacterial infection was 87.5 and 62.5, and the specificity was 86.3 and 91.3 respectively. Sensitivity comparison: pharynx swab PCT sensitivity was significantly higher than serum PCT, (P0.05). Comparison of specificity: the specificity of throat swab PCT was the same as serum PCT, the difference was not statistically significant (P0.05). There was a significant positive correlation between the level of pharyngeal swab PCT and antibiotic use and hospital stay in the bacterial infection group (rs=0.800,0.785;P0.001). 4. The positive rate of PCT in acute pharyngeal swabs of children with bacterial infection was significantly higher than that in convalescent stage (P 0.001). Conclusion: 1. When there is bacterial infection in respiratory tract, pharynx swab PCT has good sensitivity and specificity, which may be one of the indicators for judging respiratory tract bacterial infection. Pharyngeal swab PCT level can reflect the severity of bacterial infection and disease changes.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R725.6

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