血清降钙素原、超敏C反应蛋白及白细胞介素-6在小儿急性上呼吸道感染中的诊断价值

摘要

Objective To investigate the clinical application of serum procalcitonin(PCT ) ,high sensitive C reactive protein(hs‐CRP)and interleukin‐6(IL‐6)in children with acute respiratory infections .Methods 136 cases of children with acute respiratory in‐fections were selected as observation group ,according to the results of the laboratory diagnosis ,which were divided into bacterial in‐fection group and viral infection group ,at the same time ,at the same period 83 cases of healthy children were selected as control group .Comparison of the level of PCT ,hs‐CRP and IL‐6 between groups .The level of PCT ,hs‐CRP and IL‐6 before and after treat‐ment was studied at the same time .The diagnostic value of PCT ,CRP ,IL‐6 was compared .Results The level of PCT ,hs‐CRP ,IL‐6 in bacterial infection group was significantly higher than the control group ,the difference was statistically significant(P<0 .05) . After treatment ,the level of PCT ,hs‐CRP ,IL‐6 was lower than that before treatment ,the difference was statistically significant (P<0 .05) .The sensitivity ,specificity ,the positive prediction rate ,negative prediction rate and Youden index of PCR was relatively higher compared with the other two index ,the difference was statistically significant(P<0 .05) .Joint detection of sensitivity had improved ,while the specific degree and Youden index was reduced .Conclusion The levels of PCT ,hs‐CRP ,IL‐6 in children with a‐cute respiratory infections have important clinical significance .PCT is better and more real as index for judgement for bacterial in‐fection .Joint detection and comprehensive evaluation of three indicators could significantly improve the sensitivity of the acute re‐spiratory infections ,which is helpful for early diagnosis and prognosis evaluation .%目的：探讨血清降钙素原（PCT）、超敏C反应蛋白（hs‐CRP）及白细胞介素‐6（IL‐6）在小儿急性上呼吸道感染中的诊断价值。方法选取该院收治的急性上呼吸道感染患儿136例作为观察组，并根据患儿实验室诊断结果，将观察组患儿分为细菌感染组与病毒感染组，同时选取同期83例健康儿童作为对照组。对比各组PCT、hs‐CRP、IL‐6水平，同时比较观察组治疗前后PCT、hs‐CRP、IL‐6水平，比较PCT、hs‐CRP、IL‐6的诊断价值。结果细菌感染组PCT、hs‐CRP、IL‐6水平明显高于对照组，差异有统计学意义（P＜0．05）。治疗后PCT、hs‐CRP、IL‐6水平明显低于治疗前，差异有统计学意义（P＜0．05）。PCR敏感度与特异度相对较高，且阳性与阴性预测率均明显高于其他两项，约登指数也有显著提高，差异有统计学意义（P＜0．05）。三项联合检测虽然敏感度有所提高，但特异度降低，约登指数下降。结论 PCT、hs‐CRP、IL‐6对于小儿急性上呼吸道感染均有一定的临床意义，PC T作为判断是否为细菌感染的指标特异度更好，真实度更高，对三项指标的联合检测及综合评价，可显著提高急性上呼吸道感染的敏感度，对于早期病情诊断与预后评估等均具有重要的临床意义。