Diagnostic value of serum globulin, white blood cell count and high-sensitivity C-reactive protein in children with sepsis
- Author:
- No author available
- Journal Title:
- China Medicine
- Issue:
- 12
- DOI:
- 10.3760/j.issn.1673-4777.2022.12.021
- Key Word:
- 脓毒症;血清球蛋白;白细胞计数;高敏C反应蛋白
Abstract： 目的 探讨血清球蛋白、白细胞计数(WBC)和高敏C反应蛋白(hs-CRP)检测对小儿脓毒症的诊断价值.方法 收集2020年7月至2022年6月武汉大学人民医院收治的112例脓毒症患儿(脓毒症组)和133例同期普通感染患儿(对照组)的临床资料行回顾性分析.收集患儿病原学感染资料并统计分析;患儿均于入院24 h内抽取静脉血分离血清,检测球蛋白、WBC和hs-CRP水平进行比较;采用受试者工作特征(ROC)曲线分析球蛋白、WBC、hs-CRP单独与联合检测对小儿脓毒症的诊断价值.结果 2组性别分布和年龄比较差异均无统计学意义(均P>0.05).2组病原分布差异有统计学意义(P<0.05).单一病原感染患儿中支原体感染发生率最高[对照组25.5％(12/47)、脓毒症组48.6％(17/35)],混合病原感染中鼻病毒感染发生率最高[对照组42.2％(19/45)、脓毒症组34.8％(8/23)].脓毒症组球蛋白、WBC、hs-CRP水平均高于对照组[(21±4)g/L比(20±3)g/L、8.6(6.0,13.1)×109/L比7.7(5.9,9.9)×109/L、40.1(23.0,86.2)mg/L比5.2(0.6,24.2)mg/L],差异均有统计学意义(均P<0.05).ROC曲线分析结果 显示,球蛋白、WBC和hs-CRP三者联合检测诊断脓毒症的曲线下面积为0.853、敏感度为73.24％、特异度为87.88％、约登指数为0.611,高于各指标单独检测(P<0.05).结论 球蛋白、WBC和hs-CRP三者联合检测可提高对小儿脓毒症的诊断效能,具有较高的临床价值.
- [1]张璐,邹芸苏,周晓光.新生儿脓毒症早期诊断生物学标志物的研究进展[J].2021,(4).
- [2]中华医学会儿科学分会急救学组,中华医学会急诊医学分会儿科学组,中国医师协会儿童重症医师分会.儿童脓毒性休克（感染性休克）诊治专家共识（2015版）[J].2015,(22).
- [3]Guo-yue Lv,Lin An,Xiao-dong Sun,etc.Pretreatment albumin to globulin ratio can serve as a prognostic marker in human cancers: a meta-analysis[J].2018,476.
- [4]Qiong, Wu,Jun, Nie,Fu-Xia, Wu,etc.Prognostic Value of High-Sensitivity C-Reactive Protein, Procalcitonin and Pancreatic Stone Protein in Pediatric Sepsis.[J].2017,23(Spec ).
- [5]Pierrakos Charalampos,Velissaris Dimitrios,Bisdorff Max,etc.Biomarkers of sepsis: time for a reappraisal[J].2020,24(1).
- [6]Wen-Feng,Fang,Yu-Mu,Chen,Yi-Hsi,Wang,etc.Incorporation of dynamic segmented neutrophil-to-monocyte ratio with leukocyte count for sepsis risk stratification.[J].2019,9(1).
- [7]Stefano, Busani,Elisa, Damiani,Ilaria, Cavazzuti,etc.Intravenous immunoglobulin in septic shock: review of the mechanisms of action and meta-analysis of the clinical effectiveness.[J].2016.
- [8]Singer, Mervyn,Deutschman, Clifford S.,Seymour, Christopher Warren,etc.The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)[J].2016,315(8).
- [9]Crouser, Elliott D.,Parrillo, Joseph E.,Seymour, Christopher,etc.Improved Early Detection of Sepsis in the ED With a Novel Monocyte Distribution Width Biomarker[J].2017,152(3).
- [10]Jundi Bakr,Ryu Hyunryul,Lee Do-Hyun,etc.Leukocyte function assessed via serial microlitre sampling of peripheral blood from sepsis patients correlates with disease severity[J].2019,3(12).
- [11].Comparison of procalcitonin and high-sensitivity C-reactive protein for the diagnosis of sepsis and septic shock in the oldest old patients.[J].2017,17(1).
- [12]Flora, Chacha,Mariam M, Mirambo,Martha F, Mushi,etc.Utility of qualitative C- reactive protein assay and white blood cells counts in the diagnosis of neonatal septicaemia at Bugando Medical Centre, Tanzania.[J].2014,14.
- [13]Rhee, Chanu,Dantes, Raymund,Epstein, Lauren,etc.Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009-2014[J].2017,318(13).
- [14]Fleischmann-Struzek, Carolin,Goldfarb, David M.,Schlattmann, Peter,etc.The global burden of paediatric and neonatal sepsis: a systematic review[J].2018,6(3).
- [15].Amniotic fluid C-reactive protein as a predictor of infection in caesarean section: a feasibility study.[J].2018,8(1).