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目的 :探讨血清C-反应蛋白(C-reactive protein,CRP)、红细胞沉降率(Erythrocyte sedimentation rate,ESR)、乳酸脱氢酶(Lactate dehydrogenase,LDH)、血清铁蛋白(Ferritin,SF)对病因待查发热患儿的诊断效果。方法 :选取2015年2月~2016年7月我院收治的病因待查发热患儿32例,依据出院诊断分为感染性(15例)、肿瘤性(5例)和风湿免疫性(12例),比较三组患儿的CRP、ESR、LDH、SF水平,并进行ROC曲线分析。结果 :感染性、肿瘤性、风湿免疫性患儿的CRP依次升高,肿瘤性患儿的LDH高于风湿免疫性患儿,风湿免疫性患儿的LDH又高于感染性患儿。三组患儿的ESR、SF无显著差异。CRP对感染性、肿瘤性和风湿免疫性发热的诊断效果较好,LDH对感染性和肿瘤性发热的诊断效果较好,但对风湿免疫性发热的诊断效果不佳。ESR、SF对感染性、肿瘤性和风湿免疫性发热均不具有明显的诊断价值。CRP+ESR+LDH+SF4项指标联合诊断感染性、肿瘤性及风湿免疫性发热的灵敏度分别为76.25%、80.35%、94.63%,特异度分别为60.21%、65.28%、80.22%,均具有良好的诊断效果。结论 :血清CRP、ESR、LDH、SF联合对病因待查发热患儿具有良好的诊断效果,其中血清CRP和LDH单独检测仍具有一定的临床参考价值。
Objective: To investigate the effect of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH) and serum ferritin (SF) Check the diagnosis of fever in children. Methods: Thirty-two children with fever who were treated in our hospital from February 2015 to July 2016 were selected and divided into infectious (15 cases), neoplastic (5 cases) and rheumatic immunity (12 cases ). The levels of CRP, ESR, LDH and SF were compared among three groups of children and ROC curve analysis was performed. Results: The CRP in children with infectious, neoplastic and rheumatoid immunity increased in turn, and the LDH in children with neoplastic disease was higher than that in children with rheumatic immunity. The LDH in children with rheumatoid immunity was higher than that in children with infectious disease. There was no significant difference in ESR and SF between the three groups. CRP is more effective in diagnosing infectious, neoplastic and rheumatic immunity fever. LDH is more effective in diagnosing infectious and neoplastic fever, but less effective in diagnosing rheumatic immunity fever. ESR, SF on infectious, neoplastic and rheumatic immunity fever have no obvious diagnostic value. The sensitivities of CRP + ESR + LDH + SF4 combined diagnosis of infectious, neoplastic and rheumatic immunity were 76.25%, 80.35%, 94.63% and 60.21%, 65.28%, 80.22%, respectively The diagnostic results. Conclusion: The combination of serum CRP, ESR, LDH and SF has a good diagnostic value in children with fever due to etiology. Serum CRP and LDH alone still have certain clinical reference value.