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《海南医科大学学报(英文版)》
>Clinical application value of procalcitonin in the diagnosis of severe hand, foot and mouth disease combined with encephalitis
Clinical application value of procalcitonin in the diagnosis of severe hand, foot and mouth disease combined with encephalitis
Objective: To investigate the clinical application of procalcitonin in the diagnosis of severe hand, foot and mouth disease combined with encephalitis. Methods:The research retrospectively analyzed the clinical information of 100 patients hospitalized from June 2014 to June 2015 in our hospital and diagnosed with 2-stage severe hand, foot and mouth disease combined with encephalitis. Peripheral blood WBC count, CRP and PCT levels as well as bacterial etiology such as urine, sputum, blood and feces of all patients were checked on admission. Meanwhile, the cerebrospinal fluid was collected in time through lumbar puncture for routine and biochemical examination. According to the diagnostic results, patients were divided into the virus infection group (n=63 cases) and the bacterial infection group (n=37). Peripheral blood WBC count, CRP and PCT levels of two groups were compared. Lumbar puncture and cerebrospinal fluid examination was used as the“golden standard”for diagnosis of severe hand, foot and mouth disease combined with bacterial encephalitis, and clinical diagnostic efficiency of WBC, CRP and PCT were evaluated by ROC curve. Results:Analysis results showed that the peripheral blood WBC count, CRP and PCT levels of the group with severe hand, foot and mouth disease complicated with bacterial infection were higher than those of the group complicated with virus infection, and the difference was statistically significant. The sensitivity, accuracy, positive predictive value, negative predictive value and Youden index of PCT in the diagnosis of severe hand, foot and mouth disease complicated with bacterial encephalitis were better than those of WBC and CRP, and the difference was statistically significant. AUC (area under the ROC curve) of PCT was 0.931, and was significantly higher than that of WBC (0.735) and CRP (0.774), and the difference was statistically significant. Conclusion:The WBC, CRP and PCT levels significantly increased in patients with severe hand, foot and mouth disease complicated with bacterial infection, the diagnostic efficiency of PCT for the disease was better than that of WBC and CRP, and it can be used as an indicator of early diagnosis to guide the rational use of antibiotics.
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