Abstract:

Objective　To analyze the value of procalcitonin (PCT), C-reactive protein (CRP), and blood routine indicators in the diagnosis of children with respiratory tract infections. Methods　A total of 85 hospitalized children treated at Yulin Hospital, The First Affiliated Hospital of Xi'an Jiaotong University from May 2021 to September 2023 were selected for the retrospective study, including 52 boys and 33 girls. They were 3-12 years old. Their body weight was 20-33 kg. They were divided into a respiratory tract infection group (35 cases) and a non-respiratory tract infection group (50 cases) according to whether they had infections. The binary logistic regression model was used to analyze the factors influencing respiratory tract infections in the children. The receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic value of the children with respiratory tract infections. According to the types of pathogens, the children were divided into a bacterial infection group (11 cases), a mycoplasma infection (11 cases), and a viral infection group (13 cases), and the levels of PCT, CRP, and blood routine indicators were compared between the 3 groups. t, χ², and F tests were used as the statistical methods. Results　The PCT, CRP, platelet count (PLT), white blood cell count (WBC), and percentage of neutrophils (NEUT) in the respiratory tract infection group were higher than those in the non-respiratory tract infection group, with statistical differences (t=4.537, 4.472, 4.570, 4.297, and 4.453 ; all P<0.05). The results of the logistic regression model analysis showed that PCT (OR=16.750, 95%CI 3.777-74.283), CRP (OR=1.478, 95%CI 1.193-1.831), PLT (OR=10.071, 95%CI 2.911-34.843), WBC (OR=1.669, 95%CI 1.257-2.216), and NEUT (OR=1.187, 95%CI 1.083-1.301) were influential factors in the diagnosis of respiratory tract infections in the children (all P<0.05). According to ROC analysis, the sensitivities of PCT, CRP, PLT, WBC, and NEUT in the diagnosis of respiratory tract infections in the children were 0.686, 0.743, 0.714, 0.829, and 0.543, respectively; the specificities were 0.620, 0.600, 0.800, 0.780, and 0.820, respectively. The area under the curve of the combination of PCT, CRP, PLT, WBC, and NEUT in the diagnosis of respiratory tract infections in the children was 0.897. Conclusion　PCT and CRP combined with blood routine are of high value in the diagnosis of respiratory tract infections in children, and can provide reliable basis for clinicians to diagnose the pathogen types.

Key words: Respiratory tract infections,  , Procalcitonin,  , C-reactive protein,  , Blood routine,  , Children

摘要：

目的　分析降钙素原（PCT）、C反应蛋白（CRP）及血常规指标在呼吸道感染患儿中的诊断价值。方法　采用回顾性分析，选取西安交通大学第一附属医院榆林医院2021年5月至2023年9月收治的85例住院患儿，男52例、女33例，年龄3～12岁，体质量20～33 kg。根据感染情况将其分为呼吸道感染组（35例）和非呼吸道感染组（50例）。采用二元logistic逐步回归模型分析诊断呼吸道感染患儿的影响因素，绘制受试者操作特征曲线（ROC）评估PCT、CRP及血常规指标在呼吸道感染患儿中的诊断价值。以患儿感染病原体类型为依据将其分为细菌感染组（11例）、支原体感染组（11例）、病毒感染组（13例）。分析不同病原体类型PCT、CRP、血常规指标。统计学方法采用t检验、χ²检验、F检验。结果　呼吸道感染组PCT、CRP、血小板计数（PLT）、白细胞计数（WBC）、中性粒细胞百分比（NEUT）水平均高于非呼吸道感染组，差异均有统计学意义（t=4.537、4.472、4.570、4.297、4.453，均P<0.05）。Logistic回归模型分析结果显示，PCT（OR=16.750，95%CI 3.777～74.283）、CRP水平（OR=1.478，95%CI 1.193～1.831）、PLT（OR=10.071，95%CI 2.911～34.843）、WBC（OR=1.669，95%CI 1.257～2.216）、NEUT（OR=1.187，95%CI 1.083～1.301）均是诊断呼吸道感染患儿的影响因素（均P<0.05）。ROC分析，PCT、CRP、PLT、WBC、NEUT水平诊断呼吸道感染患儿的灵敏度分别为0.686、0.743、0.714、0.829、0.543，特异度分别为0.620、0.600、0.800、0.780、0.820；PCT、CRP、PLT、WBC、NEUT联合诊断呼吸道感染患儿的曲线下面积为0.897。结论　PCT、CRP联合血常规诊断儿童呼吸道感染价值较高。

关键词: 呼吸道感染, 降钙素原, C反应蛋白, 血常规, 儿童