CAJ | 학술논문

目的：研究血清降钙素原( PCT)、高敏C反应蛋白( hs-CRP)、白细胞计数( WBC)联合检测对脓毒症患儿感染类型及病情严重程度的诊断价值。方法选择2012年5月至2014年12月德州市中医院收治的60例脓毒症患儿作为研究对象,根据感染的类型分为细菌感染组和病毒感染组,每组30例；另外根据感染的严重程度又分为重度脓毒症组和轻度脓毒症组,每组30例。另随机选取同期健康体检儿童30例作为对照组。采用相关检测试剂盒测定各组患儿血清PCT、hs-CRP,并统计WBC。通过绘制受试者工作特征曲线( ROC曲线)分析PCT、hs-CRP、WBC联合诊断对脓毒症患儿的诊断价值。结果细菌感染组和病毒感染组PCT、hs-CRP、WBC水平均显著高于对照组,细菌感染组PCT、hs-CRP水平均显著高于病毒感染组[(23．3±3．3)μg/L比(2．2±1．0)μg/L,(41．1±2．2) mg/L比(22．0±2．2) mg/L],差异有统计学意义(P<0．05)。轻度脓毒症组和重度脓毒症组PCT、hs-CRP和WBC水平显著高于对照组(P<0．05),重度脓毒症组PCT和hs-CRP水平均显著高于轻度脓毒症组[(23．0±1．9)μg/L比(2．4±0．3)μg/L,(45．5±2．9) mg/L比(17．7±3．0) mg/L],差异有统计学意义(P<0．05)。 PCT、hs-CRP、WBC诊断细菌感染、病毒感染的ROC曲线下面积最大的是PCT,其次是hs-CRP、WBC。 PCT、hs-CRP、WBC诊断重度脓毒症、轻度脓毒症的ROC曲线下面积最大的是hs-CRP,其次是WBC、PCT。结论血清中PCT、hs-CRP、WBC联合诊断不同感染类型和不同严重程度的脓毒症患者有一定的临床指导价值,其中PCT诊断相比hs-CRP、WBC效果更优。
목적：연구혈청강개소원( PCT)、고민C반응단백( hs-CRP)、백세포계수( WBC)연합검측대농독증환인감염류형급병정엄중정도적진단개치。방법선택2012년5월지2014년12월덕주시중의원수치적60례농독증환인작위연구대상,근거감염적류형분위세균감염조화병독감염조,매조30례；령외근거감염적엄중정도우분위중도농독증조화경도농독증조,매조30례。령수궤선취동기건강체검인동30례작위대조조。채용상관검측시제합측정각조환인혈청PCT、hs-CRP,병통계WBC。통과회제수시자공작특정곡선( ROC곡선)분석PCT、hs-CRP、WBC연합진단대농독증환인적진단개치。결과세균감염조화병독감염조PCT、hs-CRP、WBC수평균현저고우대조조,세균감염조PCT、hs-CRP수평균현저고우병독감염조[(23．3±3．3)μg/L비(2．2±1．0)μg/L,(41．1±2．2) mg/L비(22．0±2．2) mg/L],차이유통계학의의(P<0．05)。경도농독증조화중도농독증조PCT、hs-CRP화WBC수평현저고우대조조(P<0．05),중도농독증조PCT화hs-CRP수평균현저고우경도농독증조[(23．0±1．9)μg/L비(2．4±0．3)μg/L,(45．5±2．9) mg/L비(17．7±3．0) mg/L],차이유통계학의의(P<0．05)。 PCT、hs-CRP、WBC진단세균감염、병독감염적ROC곡선하면적최대적시PCT,기차시hs-CRP、WBC。 PCT、hs-CRP、WBC진단중도농독증、경도농독증적ROC곡선하면적최대적시hs-CRP,기차시WBC、PCT。결론혈청중PCT、hs-CRP、WBC연합진단불동감염류형화불동엄중정도적농독증환자유일정적림상지도개치,기중PCT진단상비hs-CRP、WBC효과경우。
Objective To study the diagnostic value of the serum procalcitonin( PCT) combined with high-sensitivity C reactive protein(hs-CRP) and white blood cell count(WBC) detection for the infection type and severity of disease in children with sepsis. Methods A total of 60 children with sepsis in Dezhou Hospital of Traditional Chinese Medicine from May 2012 to Dec. 2014 were included as the research objects, and were divided to bacterial infection group and viral infection group according to the type of infection,30 cases in each group;and are also divided into severe sepsis and mild sepsis group according to the severity of the infection,30 cases in each group. Another 30 healthy children for health checkup during the same period were randomly included as control group. The test kit was used to detect the serum PCT,hs-CRP and WBC count,then ROC curve was drawn to analyze their diagnosis value for sepsis in children. Results The levels of hs-CRP,WBC and PCT of bacterial infection group and viral infection group were significantly higher than those in the control group,and the levels of PCT and hs-CRP of the bacterial infection group were significantly higher than those in the viral infection group [(23. 3 ± 3. 3) μg/L vs (2. 2 ± 1. 0) μg/L,(41. 1 ± 2. 2) mg/L vs (22. 0 ± 2. 2) mg/L,P<0. 05]. The levels of hs-CRP,WBC and PCT of the mild sepsis group and the severe sepsis group were significantly higher than those in the control group(P<0. 05),and the PCT and hs-CRP levels of the severe sepsis group were significantly higher than those of the mild sepsis group[(23. 0 ± 1. 9) μg/L vs (2. 4 ± 0. 3) μg/L,(45. 5 ± 2. 9) mg/L vs (17. 7 ± 3. 0) mg/L,P <0. 05]. The PCT area under the bacterial/viral ROC curve was the biggest,followed by hs-CRP and WBC, and the hs-CRP area under the mild/severe sepsis ROC curve wasthe biggest, followed by WBC, PCT. Conclusion Serum PCT and hs-CRP combined with WBC can diagnose different types and severity of sep-sis in patients,and the levels of PCT is superior to hs-CRP and WBC.