首页|肝素结合蛋白与降钙素原及C反应蛋白对儿童脓毒症早期诊断价值的比较

肝素结合蛋白与降钙素原及C反应蛋白对儿童脓毒症早期诊断价值的比较

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目的 研究血液中肝素结合蛋白(HBP)与降钙素原(PCT)及 C 反应蛋白(CRP)在儿童脓毒症早期诊断中的临床应用价值。方法 采用回顾性研究,选取 2017 年 11 月—2019 年 5 月在我院儿童重症监护室和新生儿重症监护室住院的 20 例一般脓毒症患儿(一般脓毒症组)、16 例严重脓毒症患儿(严重脓毒症组)及 12 例脓毒性休克患儿(脓毒性休克组)作为试验组,选取同期在普通病房住院的局部感染非脓毒症患儿 22 例(局部感染对照组)和非感染性疾病患儿 18 例(非感染对照组)作为对照组。分别测定各组患儿血液中 HBP、PCT、CRP 水平并进行比较,通过受试者工作特性曲线(ROC)分析比较各检测指标对脓毒症的早期诊断价值。结果 脓毒性休克组患儿血液中 HBP、PCT明显高于严重、一般脓毒症组(P<0。05),严重、一般脓毒症组患儿血液中 HBP、PCT 明显高于局部感染、非感染对照组(P<0。05)。脓毒性休克组、严重脓毒症组、一般脓毒症组患儿之间血液中 CRP 水平比较差异无显著性(P>0。05),但均显著高于非感染对照组(P<0。05)。HBP 诊断儿童脓毒症的 ROC 曲线下面积(AUC)最大(AUC=0。984),大于PCT(AUC=0。954)和CRP(AUC=0。897);当 HBP取临界值 28。225 μg/L时,其诊断效能最佳,诊断的灵敏度为 94。4%,特异度为 96。9%。结论 HBP早期诊断儿童脓毒症的应用价值高于 PCT和CRP,在临床分级方面的价值与PCT相同,可用于指导临床。
Value of heparin-binding protein versus procalcitonin and C-reactive protein in the early diagnosis of childhood sepsis
Objective To investigate the clinical application value of blood heparin-binding protein(HBP),procalcitonin(PCT),and C-reactive protein(CRP)in the early diagnosis of childhood sepsis.Methods A retrospective analysis was per-formed for 20 children with general sepsis(general sepsis group),16 children with severe sepsis(severe sepsis group),and 12 chil-dren with septic shock(septic shock group)who were admitted to the pediatric intensive care unit and the neonatal intensive care unit of our hospital from November 2017 to May 2019,and 22 non-sepsis children with local infection(local infection control group)and 18 children with non-infectious disease(non-infection control group)who were admitted to the general ward during the same period of time were enrolled as control group.The levels of blood HBP,PCT,and CRP were measured and compared between groups,and the receiver operating characteristic(ROC)curve was used to investigate the value of each index in the early diagnosis of sepsis.Results The septic shock group had significantly higher levels of blood HBP and PCT than the severe sepsis group and the general sepsis group(P<0.05),and the severe sepsis group and the general sepsis group had significantly higher levels of blood HBP and PCT than the local infection control group and the non-infection control group(P<0.05).There was no significant diffe-rence in blood CRP between the septic shock group,the severe sepsis group,and the general sepsis group(P>0.05),but all these three groups had a significantly higher level of blood CRP than the non-infection control group(P<0.05).HBP had a significantly larger area under the ROC curve than PCT and CRP in the diagnosis of childhood sepsis(0.984 vs 0.954/0.897),and HBP had the best diagnostic performance at the cut-off value of 28.225μg/L,with a sensitivity of 94.4%and a specificity of 96.9%.Conclu-sion HBP has a higher application value than PCT and CRP in the early diagnosis of childhood sepsis and has a similar value to PCT in terms of clinical classification,and therefore,it can be used to guide clinical practice.

SepsisHeparin binding proteinProcalcitoninC-reactive proteinEarly diagnosisChild

孙平平、马少春、蒋玉红、李德华

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青岛大学附属妇女儿童医院儿内科,山东 青岛 266034

脓毒症 肝素结合蛋白 降钙素原 C反应蛋白质 早期诊断 儿童

2024

精准医学杂志
青岛大学

精准医学杂志

ISSN:2096-529X
年,卷(期):2024.39(1)
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