CAJ | 학술논문

目的：探讨降钙素原（PCT ）和 C 反应蛋白（CRP）联合使用对早期诊断儿童细菌感染性肺炎的临床应用价值。方法细菌感染性肺炎患儿101例纳入细菌感染性肺炎组、非细菌感染性肺炎患儿64例纳入非细菌感染性肺炎组，非感染性疾病患儿73例纳入非感染性组。分别于治疗前检测3组患儿血清 PCT 和 CRP 水平。以痰液培养结果作为诊断败血症金标准，分别计算PCT 与 CRP 单独检测及 PCT ／CRP 序列试验、PCT ／CRP 平行试验诊断细菌感染性肺炎的灵敏度、特异度、阳性预测值、阴性预测值、约登指数和诊断准确度。结果细菌感染性肺炎组患儿 PCT 和 CRP 均明显高于非细菌感染性肺炎组和非感染组，比较差异有统计学意义（P＜0．05）。以 PCT ≥0．5 ng／mL 和 CRP ≥8 mg／mL 作为最佳截断值，PCT 诊断儿童细菌感染性肺炎的灵敏度、特异度、阳性预测值、阴性预测值、约登指数和诊断准确度分别是0．743、0．719、0．806、0．639、0．461和0．733；PCT ／CRP 序列试验的上述指标值分别是0．604、0．875、0．884、0．583、0．479和0．709，除灵敏度外，均高于 CRP 和 PCT ／CRP 平行试验的上述各指标值。结论 PCT 和 PCT ／CRP 序列试验的联合运用是较理想的儿童细菌感染性肺炎早期诊断检测手段。
목적：탐토강개소원（PCT ）화 C 반응단백（CRP）연합사용대조기진단인동세균감염성폐염적림상응용개치。방법세균감염성폐염환인101례납입세균감염성폐염조、비세균감염성폐염환인64례납입비세균감염성폐염조，비감염성질병환인73례납입비감염성조。분별우치료전검측3조환인혈청 PCT 화 CRP 수평。이담액배양결과작위진단패혈증금표준，분별계산PCT 여 CRP 단독검측급 PCT ／CRP 서렬시험、PCT ／CRP 평행시험진단세균감염성폐염적령민도、특이도、양성예측치、음성예측치、약등지수화진단준학도。결과세균감염성폐염조환인 PCT 화 CRP 균명현고우비세균감염성폐염조화비감염조，비교차이유통계학의의（P＜0．05）。이 PCT ≥0．5 ng／mL 화 CRP ≥8 mg／mL 작위최가절단치，PCT 진단인동세균감염성폐염적령민도、특이도、양성예측치、음성예측치、약등지수화진단준학도분별시0．743、0．719、0．806、0．639、0．461화0．733；PCT ／CRP 서렬시험적상술지표치분별시0．604、0．875、0．884、0．583、0．479화0．709，제령민도외，균고우 CRP 화 PCT ／CRP 평행시험적상술각지표치。결론 PCT 화 PCT ／CRP 서렬시험적연합운용시교이상적인동세균감염성폐염조기진단검측수단。
Objective To explore the early diagnosis value of C‐reactive protein (CRP) and procalcitonin (PCT ) for bacterial in‐fectious pneumonia of children .Methods A total of 101 children with bacterial infectious pneumonia ,64 children with non‐bacterial infectious pneumonia and 73 children with non‐infectious disease were selected in bacterial infectious pneumonia group ,non‐bacterial infectious pneumonia group and non‐infectious disease group respectively .Serum PCT and CRP levels were measured before treat‐ment in the three groups .With sputum culture results as gold standard for the diagnosis of bacterial infectious pneumonia ,the sensi‐tivity ,specificity ,positive predictive value ,negative predictive value ,Youden index and diagnostic accuracy of PCT ,CRP ,PCT /CRP series test and parallel test were calculated for bacterial infectious pneumonia diagnosis .Results The levels of PCT and CRP of children in bacterial infectious pneumonia group were significant higher than those of children in non‐bacterial infectious pneumonia group and non‐infectious disease group(P < 0 .05) .The sensitivity ,specificity ,positive predictive value ,negative predictive value , Youden index and diagnostic accuracy of PCT ( ≥ 0 .5 ng/mL as the best intercept point) for bacterial infectious pneumonia diagno‐sis were 0 .743 ,0 .719 ,0 .806 ,0 .639 ,0 .461 and 0 .733 .And the same values for PCT /CRP series test were 0 .604 ,0 .875 ,0 .884 , 0 .583 ,0 .479 and 0 .709 respectively .All the values were higher than those of children in non‐bacterial infectious pneumonia group and non‐infectious disease group except sensitivity .Conclusion The combination of PCT and PCT /CRP series test is ideal method for early diagnosis of bacterial infectious pneumonia with high sensitivity and specificity .