降钙素原、前白蛋白、中性粒...对儿童细菌性肠炎的诊断价值_郭凯.pdf

143临床研究 2023 年 05 月第 31 卷第 05 期作者简介：郭凯，男，主管检验师，本科。研究方向：生化免疫检验。10王玥,朱玉,王盼.判别指数对儿童缺铁性贫血和珠蛋白生成障碍性贫血的鉴别诊断效能J.检验医学与临床,2022,19(23):3273-3277.11李磊,罗桂香,李恋湘,等.珠海地区地中海贫血基因检测结果分析J.海南医学,2021,32(1):88-90.12王栋,张丹,颜新生,等.武汉市经开区人群地中海贫血基因检测结果及血液学筛查指标分析J.标记免疫分析与临床,2022,29(8):1369-1372,1440.13谢汶晃,黄林环,余学高,等.基因突变合并缺失型-地中海贫血患者血液学表型的回顾性分析J.中国实验血液学杂志,2021,29(4):1262-1265.14GE Y L,LIU C H,WANG M H,et al.Anemia combined significantly increased high-sensitivity C reactive protein and lung lesions lead to the diagnosis of granulomatosis with polyangiitis proven by lung biopsy and anti-neutrophil cytoplasmic antibody testJ.Clin Lab,2019,65(1):10.7754/Clin.Lab.2018.180733.15ARORA R D,DASS J,MAYDEO S,et al.Flow cytometric osmotic fragility test and eosin-5-maleimide dye-binding tests are better than conventional osmotic fragility tests for the diagnosis of hereditary spherocytosisJ.Int J Lab Hematol,2018,40(3):335-342.16EAHIR E,AYOTTE P,LITTLE M,et al.Anemia,iron status,and associated protective and risk factors among children and adolescents aged 3 to 19 years old from four First Nations communities in QuebecJ.Can J Public Health,2020,111(5):682-693.临床化验与检查降钙素原、前白蛋白、中性粒细胞百分比水平表达对儿童细菌性肠炎的诊断价值郭凯，邓超，吴晓鹏(河南中医药大学人民医院，郑州人民医院 检验科，河南 郑州 450000)摘要：目的 研讨降钙素原(PCT)，前白蛋白(PA)，中性粒细胞百分比(NEU%)水平表达在诊断儿童细菌性肠炎中的价值。方法 选择河南中医药大学人民医院 2021 年 4 月至 2022 年 10 月收治的 200 例疑似细菌性肠炎患儿，检测所有患儿 PCT、PA、NEU%水平，分析儿童细菌性肠炎 PCT、PA、NEU%单独检测及联合检测的诊断效能。结果 200 例疑似的细菌性肠炎患儿最终临床各项检查确诊细菌性肠炎 78 例(39.00%)，非细菌性肠炎患儿 122例(61.00%)；细菌性肠炎患儿 PCT、NEU%高于非细菌性肠炎，PA 低于非细菌性肠炎，差异有统计学意义(P 0.05)；PCT 单一检测细菌性肠炎阳性 64 例，阴性 136 例；PA 单一检测细菌性肠炎阳性 67 例，阴性 133 例；NEU%单一检测细菌性肠炎阳性 71 例，阴性 129 例；三种方法联合检验细菌性肠炎阳性 75 例，阴性 125 例。PCT、PA、NEU%单一检测与三种联合检测特异度分别为 92.62%、96.72%、96.72%、98.36%，相比较差异无统计学意义(P 0.05)；三种联合检测灵敏度(93.59%)高于 PCT、PA、NEU%单一检测(70.51%、80.77%、85.90%)，差异有统计学意义(P 0.05)；PCT、PA、NEU%单一检测与三种联合检测阳性预测值分别为 85.94%、94.03%、94.37%、97.33%，相比较差异无统计学意义(P 0.05)；三种联合检测阴性预测值(96.00%)高于 PCT、PA、NEU%单一检测(83.09%、88.72%、91.47%)，差异有统计学意义(P 0.05)。结论 儿童细菌性肠炎的诊断中应用 PCT、PA、NEU%联合检测价值较高，能对早期感染的类型进行识别，从而为治疗提供参考。关键词：儿童细菌性肠炎；降钙素原；前白蛋白；中性粒细胞百分比；诊断中图分类号：R516.1文献标志码：B DOI：10.12385/j.issn.2096-1278(2023)05-0143-03Diagnostic Value of Procalcitonin,Prealbumin,and Neutrophil Percentage Expression in Children with Bacterial EnteritisGUO Kai,DENG Chao,WU Xiaopeng(Laboratory,Henan University of Traditional Chinese Medicine Peoples Hospital,Zhengzhou Peoples Hospital,Zhengzhou Henan 450000,China)Abstract:Objective To investigate the value of expression of procalcitonin(PCT),prealbumin(PA),and neutrophil percentage(NEU%)in the diagnosis of bacterial enteritis in children.Methods From April 2021 to October 2022,200 children in our hospital with suspected bacterial enteritis were selected and tested for PCT,PA,and NEU%in all children.To analyze the diagnostic efficacy of single and combined detection of PCT,PA and NEU%in children with bacterial enteritis.Results Of the 200 suspected children with bacterial enteritis,78 cases(39.00%)were diagnosed as bacterial enteritis through various clinical examinations,while 122 cases(61.00%)were diagnosed as non bacterial enteritis;the percentage of PCT and NEU in children with bacterial enteritis was higher than that in nonbacterial enteritis,while the percentage of PA was lower than that in nonbacterial enteritis,the difference is statistically significant(P 0.05);PCT single detection of bacterial enteritis was positive in 64 cases and negative in 136 cases;there were 67 positive and 133 negative cases of bacterial enteritis detected by PA alone;single detection of NEU%for bacterial enteritis was positive in 71 cases and negative in 129 cases.The combination of the three methods tested 75 positive and 125 negative cases of bacterial enteritis.The specificity of PCT,PA,NEU%single test and 144Clinical Research,May 2023,Vol.31 No.05three combined tests were 92.62%,96.72%,96.72%,98.36%,respectively,the difference is not statistically significant.(P0.05);the positive predictive values of PCT,PA,and NEU%were 85.94%,94.03%,94.37%,and 97.33%,respectively,with no difference compared to the three combined tests(P 0.05);the sensitivity of the three combined detection methods was 93.59%,which was higher than 70.51%,80.77%,and 85.90%of the single detection methods of PCT,PA,and NEU%,the difference is statistically significant(P 0.05);the negative predictive value of the three combined tests was 96.00%,higher than 83.09%,88.72%,and 91.47%of the single tests of PCT,PA,and NEU%,the difference is statistically significant(P 0.05).Conclusion The combined detection of PCT,PA,and NEU%is highly valuable in the diagnosis of bacterial enteritis in children,and can identify the type of infection early,thereby providing a reference for treatment.Key Words:bacterial enteritis in children;procalcitonin;prealbumin;percentage of neutrophils;diagnosis细菌性和病毒性肠炎是导致小儿腹泻疾病的主要原因，虽然这两种情况临床表现相似，但是在治疗上存在很大差异，因此需要采取有效的诊断手段进行区分。目前临床鉴别细菌或病毒的常用方法是粪便标本病原体培养法，但是该种方法存在检测时间长的缺陷，因此早期不能根据病原体的类型采取相应的药物治疗，进而导致耽误最佳治疗时间1。同时病原体培养对于标本的要求也比较高，不能受到任何污染，否则结果就可能受到影响2。因此临床还需