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目的评价联合C-反应蛋白和白细胞参数对猩红热中的辅助诊断价值。方法检测40例确诊的猩红热患儿和20例正常体检儿童的C-反应蛋白(CRP)及炎性细胞改变包括总白细胞计数(WBC)及其中性粒细胞(NE)和淋巴细胞(LY)百分比,计算ROC曲线下面积(AUC),并进行AUC比较。结果猩红热组CRP及WBC、NE%明显高于对照组(P<0.01),而LY%明显低于正常组(P<0.01);猩红热患者CRP与WBC、NE%呈明显的正相关(r=0.584;0.616,P<0.01),而LY%呈负相关(r=-0.653,P<0.01);ROC曲线确立猩红热患儿WBC、NE%、LY%和CRP的最佳截断点分别为8.50(×10~9/L)、64.45%、25.42%和4.65mg/L,所得联合预测因子PRE值为-5.999+0.529WBC+0.346CRP,CRP+WBC的ROC曲线的AUC值明显大于二者单一指标。结论在猩红热临床综合确诊中,联合CRP和WBC分析指标具有实验室辅助诊断价值。
Objective To evaluate the value of combined C-reactive protein and leukocyte parameters in the diagnosis of scarlet fever. Methods C-reactive protein (CRP) and inflammatory cell changes in 40 children diagnosed with scarlet fever and 20 normal children were measured. The changes of total white blood cell count (WBC) and the percentage of neutrophils (NE) and lymphocytes (LY) , Calculate the area under the ROC curve (AUC), and compare the AUCs. Results The levels of CRP, WBC and NE% in scarlet fever group were significantly higher than those in control group (P <0.01), while those in LY% group were significantly lower than those in normal group (P <0.01). CRP was positively correlated with WBC and NE% 0.584; 0.616, P <0.01), while LY% was negatively correlated (r = -0.653, P <0.01). The best cutoff points of WBC, NE%, LY% and CRP in children with scarlet fever established by ROC curve were 8.50 × 10 ~ 9 / L), 64.45%, 25.42% and 4.65mg / L respectively. The predicted value of PRE was -5.999 + 0.529WBC + 0.346CRP. The AUC value of ROC curve of CRP + WBC was significantly higher than the single index . Conclusion In the comprehensive diagnosis of scarlet fever, the combination of CRP and WBC analysis has laboratory-assisted diagnostic value.