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目的探讨比较降钙素原(PCT)和C反应蛋白(CRP)与血常规白细胞计数(WBC)在小儿发热疾病中的应用价值及诊断意义。方法 269例发热患儿,根据诊断结果将其分为细菌感染组128例和病毒感染组141例,并将135例健康体检儿童作为对照组,同时检测三组PCT、CRP、WBC水平,比较细菌感染组3项指标的敏感性及特异性。结果细菌感染组PCT、CRP、WBC较对照组明显升高(P<0.05),但病毒感染组患儿的PCT、CRP与对照组比较差异无统计学意义(P>0.05)。细菌感染组血清PCT、CRP的敏感性及特异性(91.7%、94.7%;85.7%、87.0%)明显高于WBC(73.4%、52.6%)(P<0.05),三项炎性标志物的敏感性及特异性比较PCT>CRP>WBC。结论血清PCT、CRP对小儿细菌性发热感染的诊断价值优于WBC,联合检测血清PCT、CRP、WBC在小儿发热疾病类型的鉴别诊断中,具有重要意义值得推广。
Objective To investigate the value and diagnostic significance of comparing procalcitonin (PCT), C-reactive protein (CRP) and blood routine white blood cell count (WBC) in children with fever. Methods A total of 269 children with fever were divided into 128 cases of bacterial infection and 141 cases of viral infection according to the diagnostic results. 135 healthy children were used as control group, and the levels of PCT, CRP and WBC in three groups were also compared. The sensitivity and specificity of 3 indexes in infection group. Results The PCT, CRP and WBC in bacterial infection group were significantly higher than those in control group (P <0.05). However, there was no significant difference in PCT, CRP between control group and viral infection group (P> 0.05). The sensitivity and specificity of serum PCT and CRP in bacterial infection group were significantly higher than those in WBC (91.7%, 94.7%; 85.7%, 87.0%) (P <0.05). The three inflammatory markers Sensitivity and specificity comparison PCT> CRP> WBC. Conclusions Serum PCT and CRP are better than WBC in the diagnosis of bacterial infection in children. Combined detection of PCT, CRP and WBC in the differential diagnosis of pediatric fever is of great significance.