消化系统疾病专栏

降钙素原与 C- 反应蛋白联合评分系统诊断儿童侵袭性细菌性腹泻

  •  万宏 ,
  •  段亚群 ,
  •  周艳 ,
  •  肖珍君 ,
  •  万盛华 ,
  • 吴蔚 ,
  •  张双红 ,
  •  许增华
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  • 江西省儿童医院1.消化科,2.检验科(江西南昌 330006)

收稿日期: 2017-10-15

  网络出版日期: 2017-10-15

基金资助

江西省卫生计生委科技计划课题(No.20165502)

Combination of procalcitonin and C-reactive protein for the diagnosis of invasive bacterial diarrhea in children

  • WAN Hong ,
  • DUAN Yaqun ,
  • ZHOU Yan ,
  • XIAO Zhenjun ,
  • WAN Shenghua ,
  • WU Wei ,
  • ZHANG Shuanghong ,
  • XU Zenghua
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  • 1.Department of Digestion, 2.Department of Clinical Laboratory, Children's Hospital of Jiangxi Province, Nanchang 330006, Jiangxi, China

Received date: 2017-10-15

  Online published: 2017-10-15

摘要

目的 构建血降钙素原与C-反应蛋白联合评分系统以诊断儿童侵袭性细菌性腹泻。方法 回顾性收集住院 的急性腹泻病患儿的临床资料,将患儿分为侵袭性细菌性腹泻组与非细菌性腹泻组。以血降钙素原与C-反应蛋白为参数, 通过二分类logistic回归分析构建诊断儿童侵袭性细菌性腹泻的联合评分系统,利用受试者工作特征(ROC)曲线评价其 诊断准确性。结果 共纳入侵袭性细菌性腹泻患儿110例与非细菌性腹泻患儿108例。侵袭性细菌性腹泻组的血降钙素原 与C-反应蛋白水平明显高于非细菌性腹泻组,差异有统计学意义(P均<0.05)。 构建的联合评分系统诊断侵袭性细菌性 腹泻的ROC曲线下面积(AUC)为0.894,大于血降钙素原或C-反应蛋白(P<0.05);联合评分的最佳诊断界值为0.52,其 灵敏度为80.9%,特异度为88.9%。结论 血降钙素原与C-反应蛋白联合评分系统对儿童侵袭性细菌性腹泻诊断准确性 良好,可协助临床早期准确诊断。

本文引用格式

 万宏 ,  段亚群 ,  周艳 ,  肖珍君 ,  万盛华 , 吴蔚 ,  张双红 ,  许增华 . 降钙素原与 C- 反应蛋白联合评分系统诊断儿童侵袭性细菌性腹泻[J]. 临床儿科杂志, 2017 , 35(10) : 721 . DOI: 10.3969/j.issn.1000-3606.2017.10.001

Abstract

 Objective To construct a scoring system of combination of procalcitonin and C-reactive protein for diagnosis of invasive bacterial diarrhea in children. Methods The clinical data of hospitalized children with acute diarrhea were retrospectively analyzed. All of the children were divided into two groups, invasive bacterial diarrhea group and nonbacterial diarrhea group. The scoring system of combination of two markers for diagnosis of invasive bacterial diarrhea in children was constructed by means of two categories logistic regression analysis using procalcitonin and C- reactive protein as parameters. In addition, receiver operating characteristic curve (ROC) was used to evaluate the diagnostic accuracy. Results One hundred ten cases of invasive bacterial diarrhea and 108 cases of nonbacterial diarrhea were included. The levels of serum procalcitonin and C- reactive protein in invasive bacterial diarrhea group were significantly higher than those in nonbacterial diarrhea group, and there were statistical difference (P all < 0.05). The area under the ROC curve (AUC) of invasive bacterial diarrhea was 0.894 when the established scoring system was used, which was higher than the AUCs when either serum procalcitonin or in C- reactive protein was used (P<0.05). The best diagnostic boundary value for combination of serum procalcitonin and C- reactive protein scoring was 0.52 with a sensitivity at 80.9% and specificity at 88.9%. Conclusions The scoring system of combination of procalcitonin and C- reactive protein has good accuracy in diagnosis of invasive bacterial diarrhea in children, and can assist the early diagnosis of the disease.
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