PCT、HsCRP在儿童不明原因发热诊断中的应用

目的研究血清降钙素原(PCT)、超敏C反应蛋白(HsCRP)检测在儿童不明原因发热(FUO)临床诊断中的价值。方法采用电化学发光法和免疫比浊法检测FUO患儿血清PCT和HsCRP含量,并根据最后诊断探讨其价值。结果 244例FUO患儿中,感染性疾病(152例,62.30%)、结缔组织病(34例,13.93%)、肿瘤性疾病(20例,8.20%)是其主要原因。感染性疾病患儿血清PCT(31.65±7.26)μg/L]、HsCRP(17.52±6.43)mg/L]比健康对照组分别为(0.31±0.28)μg/L、(1.87±0.31)mg/L]显著升高(均P<0.01);非感染性疾病患儿血清PCT(0.52±0.51)μg/L]、HsCRP(1.96±0.45)mg/L]与健康对照组比较,差异无统计学意义(均P>0.05)。在感染性疾病中,细菌感染患儿血清PCT(43.24±8.34)μg/L]、HsCRP(26.74±7.05)mg/L]最高,支原体/衣原体感染次之分别为(6.72±1.65)μg/L、(15.05±2.79)mg/L],病毒感染无明显变化分别为(0.34±0.26)μg/L、(1.89±0.66)mg/L];同时,PCT和HsCRP联合检测阳性诊断率(92.63%)比单独PCT(84.21%)或HsCRP(68.42%)检测显著升高(均P<0.01)。结论血清PCT、HsCRP联合检测可以提高FUO的早期诊断率,有助于区分感染性发热和非感染性发热、细菌感染与病毒感染,对FUO患儿的及时诊断和治疗有益。

Diagnostic value of PCT and HsCRP in diagnosis of fever of unknown origin in children

Objective To study the value of procalcitonin（PCT） and high-sensitivity C-reactive protein（HsCRP） detection in the diagnosis of fever of unknown origin（FUO） in children.Methods Electrochemiluminescence and immunoturbidimetry method were adopted to detect serum PCT and HsCRP levels,and the values were evaluated according to the final diagnosis.Results Of 244 children with FUO,infectious diseases（152 cases,62.30%）,connective tissue diseases（34 cases,13.93%） and the tumor diseases（20 cases,8.20%） were the main causes of FUO.Serum PCT,HsCRP levels in children with infectious diseases were（31.65±7.26）μg/L and（17.52±6.43）mg/L respectively,which was significantly higher than those of the normal control group（0.31±0.28]μg/L and 1.87±0.31]mg/L respectively,both P〈0.01）;serum PCT and HsCRP level in children with non-infectious diseases was（0.52±0.51）μg/L and（1.96±0.45）mg/L respectively,there were no significant difference compared with the normal control group（both P〈0.05）.Of all infectious diseases,serum PCT and HsCRP levels were the highest in patients with bacterial infection（43.24±8.34]μg/L,26.74±7.05]mg/L,respectively）,the next was in patients with Mycoplasma/Chlamydia infection（6.72±1.65]μg/L,15.05±2.79]mg/L,respectively）,virus infection didn’t change obviously（0.34±0.26]μg/L,1.89±0.66]mg/L,respectively）;positive diagnosis rate of simultaneous detection of PCT and HsCRP（92.63%） was significantly higher than that of PCT（84.21%） or HsCRP（68.42%） alone（both P〈0.01）.Conclusion Combination detection of serum PCT and HsCRP can improve the early diagnosis of FUO,distinguish infectious fever from non-infectious fever,bacterial from viral infection,which is beneficial to timely diagnosis and treatment of FUO in children.