降钙素原测定在小儿肠炎鉴别诊断中的应用价值分析(1)
[摘要] 目的 研究通过对降钙素原(PCT)进行检测，明确其在小儿肠炎中的诊断价值。 方法 研究对象为2013年1月～2014年11月我院门诊收集的150例肠炎患儿，其中80例细菌性肠炎患儿作为观察组，70例病毒性肠炎患儿作为对照组，两组患儿均进行血清降钙素原、超敏C反应蛋白、白细胞的测定，以此进行临床评价。 结果 细菌性小儿肠炎中PCT诊断的敏感性为91.25%，特异性为97.50%。两组患儿在CRP、WBC、PCT三项指标检测阳性率比较，差异有统计学意义(P<0.05)。 结论 血清降钙素原、超敏C反应蛋白、白细胞等指标的测定有助于临床对小儿肠炎的鉴别诊断；在细菌性肠炎中血清降钙素原检测的诊断较其余指标临床使用价值更高，值得在临床推广。
[关键词] 小儿肠炎；降钙素原；超敏C反应蛋白；白细胞计数
[中图分类号] R725.7 [文献标识码] B [文章编号] 2095-0616(2015)13-82-03
[Abstract] Objective To investigate the clinically diagnostic value of procalcitonin (PCT) on pediatric enteritis by determinate. Methods 150 children with pediatric enteritis admitted by the outpatient service of our hospital from January 2013 to December 2013 were selected as research subject， in which 80 children with bacterial enteritis were divided into the observation group， 70 patients with viral enteritis children were divided into the control group， serum procalcitonin， hypersensitive c-reactive protein and white blood cells in two groups were measured， and clinically diagnosed. Results The diagnostic sensitivity and specificity of PCT in pediatric bacterial enteritis were 91.25% and 97.50% respectively. The determination rates of three positive indicators including CRP， WBC and PCT were compared (P<0.05)， and there were statistically significant differences. Conclusion The determinations on the serum procalcitonin， hypersensitive C-reactive protein and white blood cells make for clinically differential diagnosis of pediatric enteritis. And they deliver higher clinical use value in the determination on serum procalcitonin of bacterial enteritis in the diagnosis when compared to that of rest indicators， is worth popularizing in clinical practices.
[Key words] Pediatric enteritis； Procalcitonin；Hypersensitive C-reactive protein； Count of white blood cells
小儿肠炎的致病菌包含细菌和病毒，不同病原体导致的肠炎均有相似的临床表现，临床诊断具有较大难度。与大便培养检验相比血常规检测具有诊断快速的优点。相关研究发现，发生细菌感染时，机体内部的降钙素原(PCT)含量会明显上升，但病毒感染其含量较低，故其被认为是对细菌和病毒感染进行早期鉴别诊断的标志物[1-7]。为探究降钙素对小儿肠炎的诊断价值，本研究对不同类型的肠炎患儿进行血清降钙素原、超敏C反应蛋白、白细胞的测定，现将结果报道如下。
1 资料与方法
1.1 一般资料
研究对象为2013年1月～2014年11月门诊收集的150例肠炎患儿，患儿主要临床症状为发热、呕吐者、脱水、代谢性酸中毒等。其中80例细菌性肠炎患儿作为观察组，男48例，女32例；年龄0.5～11岁，平均(5.3±2.6)岁；病程1～15d，平均(7.3±2.1) d；每日大便次数5～17次，平均(6.5±2.4)次；病情程度：轻型23例，中型38例，重型19例。70例病毒性肠炎患儿作为对照组，男38例，女32例；年龄0.3～10岁，平均(5.8±3.2)岁；病程1～15d，平均(7.5±2.3)d；每日大便次数5～17次，平均(6.1±2.0)次；病情程度：轻型21例，中型32例，重型17例。两组患儿在上述资料的比较，上差异无统计学意义(P>0.05)，具有可比性。具体见表1。两组患儿家属均对研究过程知情，并自愿参与。
1.2 诊断标准
1.2.1 细菌性肠炎诊断标准 具有腹痛、腹泻和里急后重等症状，大便常规检测呈黏液脓血便，镜检白细胞≥10/HP，并伴有少量红细胞及脓细胞，大便细菌培养检出致病菌。, 百拇医药(何昀)
[关键词] 小儿肠炎；降钙素原；超敏C反应蛋白；白细胞计数
[中图分类号] R725.7 [文献标识码] B [文章编号] 2095-0616(2015)13-82-03
[Abstract] Objective To investigate the clinically diagnostic value of procalcitonin (PCT) on pediatric enteritis by determinate. Methods 150 children with pediatric enteritis admitted by the outpatient service of our hospital from January 2013 to December 2013 were selected as research subject， in which 80 children with bacterial enteritis were divided into the observation group， 70 patients with viral enteritis children were divided into the control group， serum procalcitonin， hypersensitive c-reactive protein and white blood cells in two groups were measured， and clinically diagnosed. Results The diagnostic sensitivity and specificity of PCT in pediatric bacterial enteritis were 91.25% and 97.50% respectively. The determination rates of three positive indicators including CRP， WBC and PCT were compared (P<0.05)， and there were statistically significant differences. Conclusion The determinations on the serum procalcitonin， hypersensitive C-reactive protein and white blood cells make for clinically differential diagnosis of pediatric enteritis. And they deliver higher clinical use value in the determination on serum procalcitonin of bacterial enteritis in the diagnosis when compared to that of rest indicators， is worth popularizing in clinical practices.
[Key words] Pediatric enteritis； Procalcitonin；Hypersensitive C-reactive protein； Count of white blood cells
小儿肠炎的致病菌包含细菌和病毒，不同病原体导致的肠炎均有相似的临床表现，临床诊断具有较大难度。与大便培养检验相比血常规检测具有诊断快速的优点。相关研究发现，发生细菌感染时，机体内部的降钙素原(PCT)含量会明显上升，但病毒感染其含量较低，故其被认为是对细菌和病毒感染进行早期鉴别诊断的标志物[1-7]。为探究降钙素对小儿肠炎的诊断价值，本研究对不同类型的肠炎患儿进行血清降钙素原、超敏C反应蛋白、白细胞的测定，现将结果报道如下。
1 资料与方法
1.1 一般资料
研究对象为2013年1月～2014年11月门诊收集的150例肠炎患儿，患儿主要临床症状为发热、呕吐者、脱水、代谢性酸中毒等。其中80例细菌性肠炎患儿作为观察组，男48例，女32例；年龄0.5～11岁，平均(5.3±2.6)岁；病程1～15d，平均(7.3±2.1) d；每日大便次数5～17次，平均(6.5±2.4)次；病情程度：轻型23例，中型38例，重型19例。70例病毒性肠炎患儿作为对照组，男38例，女32例；年龄0.3～10岁，平均(5.8±3.2)岁；病程1～15d，平均(7.5±2.3)d；每日大便次数5～17次，平均(6.1±2.0)次；病情程度：轻型21例，中型32例，重型17例。两组患儿在上述资料的比较，上差异无统计学意义(P>0.05)，具有可比性。具体见表1。两组患儿家属均对研究过程知情，并自愿参与。
1.2 诊断标准
1.2.1 细菌性肠炎诊断标准 具有腹痛、腹泻和里急后重等症状，大便常规检测呈黏液脓血便，镜检白细胞≥10/HP，并伴有少量红细胞及脓细胞，大便细菌培养检出致病菌。, 百拇医药(何昀)