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目的:通过检测幼年特发性关节炎(JIA)患儿血清中降钙素原(PCT)的改变,以探讨PCT在JIA中的临床意义。方法:检测该科150例JIA患儿血清PCT和C反应蛋白(CRP)值,比较PCT和CRP对诊断JIA非病毒感染的敏感性、特异性、阳性预测值、阴性预测值,同时检测PCT在JIA各种临床类型中的表达情况。结果:PCT值在JIA非病毒感染(包括细菌、支原体等)组为(3.26±0.94)ng/mL,明显高于JIA病毒感染组(0.05±0.01)ng/mL、JIA非感染组(0.19±0.01)ng/mL及对照组(0.02±0.01)ng/mL,差异有统计学意义(P<0.05),而血清PCT值在JIA病毒感染组、对照组之间的差异无统计学意义(P>0.05)。以PCT≥0.5 ng/mL为诊断非病毒感染的阳性阈值,敏感性为76.92%,特异性为87.60%,阳性预测值55.56%,阴性预测值94.96%,阳性似然比15.23,阴性似然比0.22。98.99%的JIA非感染组PCT值≤0.5 ng/mL,中位数为0.2 ng/mL。66.67%的JIA非感染组PCT值≤0.1 ng/mL。结论:检测血清PCT值对于JIA患儿并发非病毒性感染具有重要的鉴别意义,其预测感染价值优于CRP。可考虑推荐PCT值>0.5 ng/mL作为诊断JIA合并感染的临界值。
Objective: To investigate the clinical significance of PCT in detecting JIA by detecting the changes of procalcitonin (PCT) in children with juvenile idiopathic arthritis (JIA). Methods: The serum PCT and C-reactive protein (CRP) values of 150 children with JIA were detected. The sensitivity, specificity, positive predictive value and negative predictive value of PCT and CRP in diagnosing JIA non-viral infection were compared. JIA expression in various clinical types. Results: The PCT value was (3.26 ± 0.94) ng / mL in JIA non-virus infection group (including bacteria and mycoplasma), significantly higher than that in JIA virus infection group (0.05 ± 0.01) ng / mL, JIA noninfection group 0.01) ng / mL and the control group (0.02 ± 0.01) ng / mL, the difference was statistically significant (P <0.05), while there was no significant difference in the serum PCT value between the JIA virus infected group and the control group > 0.05). With PCT≥0.5 ng / mL as the positive threshold for diagnosis of non-viral infection, the sensitivity was 76.92%, the specificity was 87.60%, the positive predictive value was 55.56%, the negative predictive value was 94.96%, the positive likelihood ratio was 15.23, the negative likelihood ratio The PCT value of 0.22.98.99% JIA non-infected group was ≤0.5 ng / mL with a median of 0.2 ng / mL. The PCT value of 66.67% JIA non-infected group was ≤0.1 ng / mL. Conclusion: Detecting serum PCT value is of great significance for the diagnosis of non-viral infection in children with JIA. The predictive value of infection is better than that of CRP. Consider recommending PCT values> 0.5 ng / mL as a cut-off for diagnosis of JIA co-infection.