多指标联合检测在291例儿童不明原因发热中的诊断价值

发布时间：2018-05-03 00:40

本文选题：白细胞计数 + 乳酸脱氢酶　；参考：《中国现代医学杂志》2017年25期

【摘要】：目的探讨白细胞(WBC)计数、乳酸脱氢酶(LDH)、C反应蛋白(CRP)、血沉(ESR)、降钙素原(PCT)5指标联合检测在儿童不明原因发热中的诊断价值。方法收集2010年6月1日至2015年12月31日因发热2周的住院患儿,出院诊断明确者291例。其中感染组202例,风湿组74例,肿瘤组15例。收集3组患儿WBC、LDH、CRP、ESR、PCT值,求得均值进行比较,并通过ROC曲线分析各组单独及联合检测对儿童不明原因发热中的诊断价值。结果 3组WBC、LDH、CRP、ESR、PCT平均值均较正常值升高。风湿组患儿血清CRP、ESR、PCT平均值较感染组高,肿瘤组LDH、CRP和ESR较感染组高。根据ROC曲线下面积(AUC),感染组诊断价值较高者是CRP(0.672)和ESR(0.697),风湿组诊断价值较高者是CRP(0.739)和ESR(0.739)和PCT(0.835),而肿瘤组诊断价值较高者为PCT(0.827)和CRP(0.711)。感染组和肿瘤组5项指标联合检测AUC值较单独检测升高,风湿组5项指标联合检测AUC值低于PCT单独检测时AUC值,但高于其他4项指标单独检测。结论 WBC、LDH、CRP、ESR、PCT各指标单独检测对风湿性疾病及肿瘤性疾病的诊断有一定的价值,对感染性疾病的诊断价值有限。5项指标联合检测对儿童不明原因发热的病因诊断价值优于单独检测。
[Abstract]:Objective to investigate the diagnostic value of WBC- count, lactate dehydrogenase (LDH) C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and procalcitonin (PCT) in children with fever of unknown origin. Methods 291 hospitalized children with fever for 2 weeks from June 1, 2010 to December 31, 2015 were collected. There were 202 cases in infection group, 74 cases in rheumatism group and 15 cases in tumor group. The PCT values of the three groups were collected and compared, and the diagnostic value of each group was analyzed by ROC curve analysis alone and jointly in children with fever of unknown origin. Results the mean values of ESR-PCT in the three groups were higher than those in the normal group. In rheumatic group, the mean value of serum CRP- ESR-PCT was higher than that of infected group, and the levels of LDH-CRP and ESR in tumor group were higher than those in infected group. According to the area under the ROC curve, the diagnostic value of the infected group was higher than that of the infection group (0.672) and the diagnosis value of the rheumatism group was 0.739) and the value of the diagnosis of the disease was 0.835) and the higher diagnostic value of the tumor group was 0.827) and 0.7111g. The combined detection of AUC in infection group and tumor group was higher than that in single test, and the AUC value in rheumatic group was lower than that in PCT alone, but higher than that in other 4 indexes. Conclusion it is valuable to diagnose rheumatic diseases and tumor diseases by single detection of ESR-PCT, and the combined detection of 5 indexes for infectious diseases is better than that for the etiological diagnosis of children with fever of unknown origin.
【作者单位】：中南大学湘雅医院儿科;
【分类号】：R725

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