[1]吴立强,陈建平,何念海.评价PCT、PLT、CRP、ESR和WBC对川崎病的诊断价值[J].第三军医大学学报,2016,38(23):2527-2531.
 Wu Liqiang,Chen Jianping,He Nianhai.Diagnostic values of procalcitonin, platelet, C-reactive protein, erythrocyte sedimentation rate and white blood cell count for Kawasaki disease[J].J Third Mil Med Univ,2016,38(23):2527-2531.
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评价PCT、PLT、CRP、ESR和WBC对川崎病的诊断价值(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
38卷
期数:
2016年第23期
页码:
2527-2531
栏目:
临床医学
出版日期:
2016-12-15

文章信息/Info

Title:
Diagnostic values of procalcitonin, platelet, C-reactive protein, erythrocyte sedimentation rate and white blood cell count for Kawasaki disease
作者:
吴立强陈建平何念海
第三军医大学西南医院儿科;西安雁塔天佑儿童医院
Author(s):
Wu Liqiang Chen Jianping He Nianhai

Department of Pediatrics, Southwest Hospital, Third Military Medical University, Chongqing, 400038; Protect Enfant Hospital Xi’an, Xi’an, Shaanxi Province, 710065, China

关键词:
川崎病诊断降钙素原C反应蛋白红细胞沉降率血小板计数白细胞计数
Keywords:
Kawasaki disease diagnostic tests procalcitonin C-reactive protein erythrocyte sedimentation rate blood platelets leukocyte count
分类号:
R446.11; R725.512
文献标志码:
A
摘要:

目的      评价5种实验诊断指标——降钙素原(procalcitonin,PCT)、血小板计数(blood platelet,PLT)、C反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)和白细胞计数(white blood cell count,WBC)及其联合试验在川崎病临床诊断中的价值。 方法      从2014年3月至2016年2月在西南医院儿科住院部及门诊就诊怀疑川崎病的所有儿童中,选取均检测PCT、PLT、CRP、ESR和WBC的儿童161例,以临床标准(临床症状及B超结果)作为金标准最终确诊92例为川崎病组(包括不完全川崎病和不典型川崎病),69例为疑似川崎病但最终排除川崎病诊断的其他疾病。绘制受试者工作特征曲线(ROC曲线),确定诊断截断点。 结果      诊断截断点分别是PCT:0.25 ng/mL,CRP:8.04 mg/L,ESR:35 mm/h,PLT:330×109/L,WBC:15.0×109/L。5种检验方法ROC曲线下面积分别是PCT:0.766,CRP:0.727,ESR:0.699,PLT:0.702,WBC:0.660。检验的灵敏度、特异度、正确率、阳性预测值、阴性预测值、阳性似然比、阴性似然比,PCT+ESR+PLT平行试验分别是96.7%、30.4%、68.3%、65.0%、87.5%、1.33、0.19,PCT+ESR+PLT系列试验分别是19.6%、95.7%、52.2%、85.7%、50.8%、4.01、0.86。结论    PCT和CRP的特异度、灵敏度、正确率、阴性预测值、阳性预测值接近,且优于ESR、PLT和WBC,PCT+ESR+PLT联合试验对川崎病的诊断意义较大。

Abstract:

Objective     To evaluate the diagnostic values of procalcitonin (PCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), blood platelet (PLT) and white blood cell count (WBC) for Kawasaki disease. Methods     A total of 161 children suspected to Kawasaki disease admitted in our hospital from March 2014 to February 2016 were enrolled in this study. They were examined for the levels of PCT, CRP, ESR, PLT and WBC. With the clinical symptoms and B ultrasound examination as the golden standard, 92 cases of the 161 children (incomplete and atypical Kawasaki disease) were confirmed having Kawasaki disease, and the other 69 cases were excluded. Receiver operating characteristic curve (ROC) analysis was used to determine the diagnostic cut-off values. Results     The cut-off point was 0.25 ng/mL for PCT, 8.04 mg/L for CRP, 35 mm/h for ESR, 330×109/L for PLT, and 15.0×109/L for WBC. The areas under ROC curves of PCT, PLT, CRP, ESR and WBC were 0.766, 0.727, 0.699, 0.702, 0.702 and 0.660 respectively in the Kawasaki disease diagnostic tests. The sensitivity, specificity, accuracy, positive and negative predictive values, positive likelihood ratio, negative likelihood ratio of parallel tests of PCT+ESR+PLT were 96.7%, 30.4%, 68.3%, 65.0%, 87.5%, 1.33 and 0.19, respectively, and those of serial tests of PCT+ESR+PLT were 19.6%, 95.7%, 52.2%, 85.7%, 50.8%, 4.01 and 0.86, respectively in the diagnosis of Kawasaki disease. Conclusion     The sensitivity, specificity, accuracy, positive and negative predictive values of PCT are closely related to those of CRP, and are better to those of ESR, PLT and WBC. The combined detection of PCT+ESR+PLT is of important value in the diagnosis of Kawasaki disease.

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更新日期/Last Update: 2016-12-06