咽拭子降钙素原在小儿呼吸道感染疾病中应用价值探讨

发布时间：2019-01-05 11:51

【摘要】：目的:探讨咽拭子PCT在小儿呼吸道细菌感染性疾病中的应用价值。方法:选取2016年1月至2016年12月期间在吉林大学第一医院小儿呼吸一科病房住院的120例急性呼吸道感染患儿为研究对象,分为细菌感染组、病毒感染组、肺炎支原体感染感染组,每组各40例。对所有被选定患儿进行咽拭子PCT水平检测,同时对血常规、CRP、血清PCT、九项呼吸道感染病原体Ig M抗体进行测定。在住院期间给予相应的规范化治疗。治疗好转后复查上述异常指标。并观察患儿抗生素使用及住院时间。数据采用SPSS22.0统计软件进行分析,计量资料以均数标准差((?)±s)表示,数据为正态分布,组间比较采用t检验,分类计数资料以例数(百分比)表示,比较采用x~2检验。两两比较采用卡方分割法,通过调整检验水准(α/比较次数)减少一类误差。相关分析采用Spearman相关检验。检验水准α为0.05。结果:1.细菌感染组患儿咽拭子PCT、血清PCT的阳性检出率最高,支原体感染组其次,病毒感染组最低,三者比较有统计学意义(P0.001),其中细菌感染组与肺炎支原体感染组、病毒感染组比较差异有统计学意义(P0.0167),而肺炎支原体感染组与病毒感染组比较差异有没有统计学意义(P0.0167)。2.咽拭子PCT及血清PCT区分细菌和非细菌感染的敏感度分别为87.5%,62.5%;特异度分别为86.3%,91.3%。敏感度比较:咽拭子PCT敏感度高于血清PCT,差异均有统计学意义(P0.05)。特异度比较:咽拭子PCT的特异度与血清PCT一致,差异无统计学意义(P0.05)。3.细菌感染组患儿用抗生素前咽拭子PCT水平与抗生素使用及住院时间均呈显著正相关(rs=0.800,0.785;P0.001)。4.细菌感染组患儿急性期咽拭子PCT阳性率明显高于恢复期,差异有统计学意义(x~2=42.076,P0.001)。结论:1.当呼吸道存在细菌感染时,咽拭子PCT具备良好的敏感性及特异性,可能是一个判断呼吸道细菌感染的指标之一。2.咽拭子PCT水平能反应细菌感染的严重程度及病情变化。
[Abstract]:Objective: to investigate the application value of pharyngeal swab PCT in children with respiratory tract bacterial infection. Methods: from January 2016 to December 2016, 120 children with acute respiratory infection (ARI) who were hospitalized in Department of Pediatric Respiratory, first Hospital of Jilin University were divided into bacterial infection group and viral infection group. Mycoplasma pneumoniae infection group, 40 cases in each group. The PCT level of throat swab was measured in all selected children, and the blood routine, Ig M antibody of nine respiratory tract infection pathogens in serum of CRP, were detected at the same time. The corresponding standardized treatment was given during the period of hospitalization. The above abnormal indexes were reviewed after treatment. The antibiotic use and hospitalization time were observed. The data were analyzed by SPSS22.0 statistical software. The measured data were expressed as mean standard deviation (?) 卤s), the data were normal distribution, the comparison between groups was expressed by t test, and the classified count data was expressed as the number of cases (percentage). X2 test was used for comparison. The chi-square method is used in pairwise comparison to reduce a class of errors by adjusting the test level (伪 / comparison times). Correlation analysis was performed with Spearman correlation test. The test level is 0. 05. Results: 1. The positive rate of PCT in pharyngeal swab PCT, was the highest in bacterial infection group, followed by mycoplasma infection group and virus infection group. There were significant differences among the three groups (P0.001), among which bacterial infection group and mycoplasma pneumoniae infection group. There was significant difference in virus infection group (P0.0167), but there was no statistical difference between mycoplasma pneumoniae infection group and virus infection group (P0.0167). 2. The sensitivity of pharyngeal swab PCT and serum PCT to distinguish bacterial infection from non-bacterial infection was 87.5 and 62.5, and the specificity was 86.3 and 91.3 respectively. Sensitivity comparison: pharynx swab PCT sensitivity was significantly higher than serum PCT, (P0.05). Comparison of specificity: the specificity of throat swab PCT was the same as serum PCT, the difference was not statistically significant (P0.05). There was a significant positive correlation between the level of pharyngeal swab PCT and antibiotic use and hospital stay in the bacterial infection group (rs=0.800,0.785;P0.001). 4. The positive rate of PCT in acute pharyngeal swabs of children with bacterial infection was significantly higher than that in convalescent stage (P 0.001). Conclusion: 1. When there is bacterial infection in respiratory tract, pharynx swab PCT has good sensitivity and specificity, which may be one of the indicators for judging respiratory tract bacterial infection. Pharyngeal swab PCT level can reflect the severity of bacterial infection and disease changes.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.6

【相似文献】