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目的通过联合检测血清CD64、降钙素原(PCT)与C-反应蛋白(CRP),探讨其在儿科发热患儿细菌感染的诊断价值,为临床抗生素使用提供指导。方法采用回顾性分析的方法分析2013年1月-2015年1月在该院因发热而住院的患儿,根据患儿的临床表现以及实验室诊断项目,分为细菌感染组,非细菌感染组,风湿性疾病组。体检健康的学龄前儿童为正常对照组。所有的患儿和正常对照组儿童在入院初24 h内分别采集静脉血检测CD64及PCT、CRP。结果将细菌感染组、非细菌感染组、风湿性疾病组分别与对照组进行比较,细菌感染组CD64值(4.09±0.46)高于对照组(1.16±0.07),差异有统计学意义(t=2.986,P<0.05),非细菌感染组(1.27±0.14)、风湿性疾病组(1.19±0.07),CD64值与对照组相比较差异无统计学意义(t值分别为1.552、1.234,均P>0.05)。细菌感染组、风湿性疾病组PCT值、CRP值高于对照组,差异有统计学意义(t值分别为3.215、2.786、3.016、8.221,均P<0.05),但细菌感染组PCT值高于风湿性疾病组,差异有统计学意义(t=2.985,P<0.05),风湿性疾病组CRP最高,与其余各组比较差异有统计学意义(t值分别为6.254、8.314、8.221,均P<0.05)。CD64诊断细菌感染的敏感度为88.75%,为3个指标中最高。结论 CD64、PCT与CRP均可作为早期诊断儿科细菌感染性疾病的指标,CD64作为细菌感染性指标的诊断价值最大。
Objective To explore the diagnostic value of serum CD64, procalcitonin (PCT) and C-reactive protein (CRP) in children with pediatric fever and provide guidance for the clinical use of antibiotics. Methods A retrospective analysis was performed on children hospitalized for fever from January 2013 to January 2015. The patients were divided into bacterial infection group and non-bacterial infection group according to their clinical manifestations and laboratory diagnostic items , Rheumatic disease group. Healthy pre-school children as a normal control group. All children and normal control group were collected venous blood samples of CD64 and PCT, CRP within 24 hours after admission. Results The bacterial infection group, non-bacterial infection group and rheumatic disease group were compared with those of the control group respectively. The CD64 value of the bacterial infection group (4.09 ± 0.46) was higher than that of the control group (1.16 ± 0.07), the difference was statistically significant (t = 2.986, P <0.05), non-bacterial infection group (1.27 ± 0.14), rheumatic disease group (1.19 ± 0.07), CD64 value compared with the control group, the difference was not statistically significant (t values were 1.552,1.234, P > 0.05). The PCT and CRP values of bacterial infection group and rheumatic disease group were higher than those of the control group (t = 3.215, 2.786, 3.016, 8.221 respectively, all P <0.05) Rheumatic disease group, the difference was statistically significant (t = 2.985, P <0.05), rheumatic disease group CRP highest, with the remaining groups were statistically significant differences (t values were 6.254,8.314,8.221, respectively, P <0.05). The sensitivity of CD64 to diagnose bacterial infection was 88.75%, which was the highest among the 3 indicators. Conclusions Both CD64, PCT and CRP can be used as indicators for early diagnosis of pediatric bacterial infections. CD64 is the most valuable diagnostic marker for bacterial infections.