摘要
目的探讨降钙素原(PCT)、D-二聚体(D-D)及血小板数量(PLT),血小板分布宽度(PDW)、平均血小板体积(MPV)、大血小板比例(P-LCR)在鉴别诊断儿童细菌性肺炎中的应用价值。方法选取2018年1~12月在玉林市红十字会医院儿科治疗的178例肺炎患儿作为研究对象,其中A组细菌性肺炎77例,B组非细菌性肺炎101例,B组又分为病毒性肺炎45例(B1组)及支原体肺炎56例(B2组)。治疗前检测各组患儿的PCT、D-D、PLT、PDW、MPV和P-LCR。采用受试者工作曲线(ROC)评价PCT、D-D、PLT、MPV、P-LCR五个指标单独诊断细菌性肺炎的效能。结果 A组患儿的PCT、D-D、PLT、MPV、P-LCR水平分别为(1.316±0.847) ng/mL、(1.258±0.802) mg/L、(404.88±61.271)×10^9/L、(9.469±0.834) fL、(20.475±5.321)%,B1组分别为(0.396±0.251) ng/mL、(0.649±0.325) mg/L、(295.33±59.901)×10^9/L、(9.011±0.713) fL、(15.056±4.916)%,B2组分别为(0.368±0.248) ng/mL、(0.624±0.323) mg/L、(311.04±74.818)×10^9/L、(9.036±0.709) fL、(17.111±5.419)%,A组均高于B1、B2组,差异均有统计学意义(P<0.05),而B1与B2组比较差异均无统计学意义(P>0.05);A组、B1组、B2组患儿的PDW比较差异无统计学意义(P>0.05);绘制ROC曲线评价相关指标对细菌性肺炎的诊断效能:PCT、D-D、PLT、MPV、P-LCR的曲线下面积(AUC)分别为:0.867、0.769、0.848、0.704、0.731,均介于0.7~0.9 (P均<0.05),敏感度分别为0.817、0.662、0.766、0.686、0.780,特异性分别为0.890、0.823、0.802、0.614、0.584。其中PCT的AUC最大,灵敏度和特异性最高。结论 PCT、D-D、PLT、MPV、P-LCR检测对儿童细菌性肺炎的诊断有一定价值,其中PCT的诊断价值最高。
Objective To investigate the value of procalcitonin(PCT), D-dimer(D-D), and platelet count(PLT), mean platelet volume(MPV), platelet-large cell ratio(P-LCR) in the differential diagnosis of bacterial pneumonia in children. Methods A total of 178 pneumonia children in Yulin Red Cross Society Hospital from January, 2018 to December, 2018 were respectively reviewed and assigned into group A(bacterial pneumonia, 77 cases) and group B(non-bacterial pneumonia, 101 cases), of which group B were further divided into group B1(viral pneumonia, 45 cases)and group B2(mycoplasma pneumonia group, 56 cases) according to the diagnostic criteria for pathogens causing pulmonary infections. PCT, D-D, PLT, MPV, P-LCR were detected in each group of children before treatment. The receiver operating characteristic curve(ROC) was used to evaluate the effectiveness of PCT, D-D, PLT, MPV, P-LCR in individual diagnosis of bacterial pneumonia. Results The levels of PCT, D-D, PLT, MPV, P-LCR were(1.316±0.847) ng/mL,(1.258±0.802) mg/L,(404.88±61.271)×10^9/L,(9.469±0.834) f L,(20.475±5.321)% in group A,(0.396±0.251) ng/mL,(0.649±0.325) mg/L,(295.33±59.901)×10^9/L,(9.011±0.713) fL,(15.056±4.916)% in group B1,(0.368±0.248) ng/mL,(0.624±0.323) mg/L,(311.04±74.818)×10^9/L,(9.036±0.709) fL,(17.111±5.419)% in group B2;the levels were significantly higher in group A than group B1 and group B2(P<0.05), but showed no significant difference between group B1 and group B2(P>0.05). PDW showed no significant difference among group A, group B1, and group B2(P>0.05).ROC showed that the area under the curve(AUC) of PCT, D-D, PLT, MPV, P-LCR were 0.867, 0.769, 0.848, 0.704,0.731, which were all in the rage of 0.7 to 0.9(all P<0.05), with the sensitivity of 0.817, 0.662, 0.766, 0.686, 0.780 and specificity of 0.890, 0.823, 0.802, 0.614, 0.584. PCT had the largest AUC, and the highest sensitivity and specificity. Conclusion PCT, D-D, PLT, MPV, P-LCR test had certain values in the differential diagnosis of children with bacterial pneumonia, and P
作者
赵凤华
李燕妮
ZHAO Feng-hua;LI Yan-ni(Department of Clinical Laboratory,Yulin Red Cross Society Hospital,Yulin 537000,Guangxi,CHINA)
出处
《海南医学》
CAS
2019年第11期1365-1368,共4页
Hainan Medical Journal
基金
广西医药卫生科研课题(编号:Z20170245)
