目的 探讨肝素结合蛋白(HBP)在儿童细菌感染性疾病诊断中的价值.方法 随机选取2015年6月至2016年6月感染性疾病患儿72例,其中细菌感染组50例,病毒感染组22例,同时选取28例健康体检儿童为健康组.检测三组患儿血清HBP、降钙素原(PCT)和超敏C反应蛋白(hs-CRP)水平,绘制ROC曲线分析各指标对儿童细菌感染的诊断价值,并探讨细菌感染儿童血清HBP与PCT、hs-CRP的相关性.结果 细菌感染组患儿HBP、PCT和hs-CRP水平均显著高于病毒感染组和健康组(P<0.01).HBP、PCT、hs-CRP诊断的ROC曲线下面积为0.902、0.861、0.809,最佳临界值分别为8.34μg/L、0.55μg/L、16.48 mg/L,灵敏度为76.0%、80.0%、76.0%,特异度为92.0%、80.0%、80.0%.联合检测HBP、PCT、hs-CRP的灵敏度为76.0%、特异度为100.0%.细菌感染组患儿血清HBP和PCT、hs-CRP均呈显著正相关(P<0.01),血清PCT和hs-CRP也显著正相关(P<0.01).结论 血清HBP、PCT、hs-CRP是诊断儿童细菌感染性疾病的敏感指标,其中HBP的诊断价值优于PCT和hs-CRP,三者联合检测可提高特异度,减少误诊.%Objective To investigate the value of Heparin-binding protein(HBP)in diagnosis of pediatric bacterial infections. Methods A total of 72 children were randomly enrolled from June 2015 to June 2016 for treatment of infectious diseases,including 50 cases in bacterial infection and 22 cases in viral infection,while 28 healthy children served as healthy group. The serum HBP,procalcitonin(PCT)and hypersensitive C-reactive protein(hs-CRP)levels were detected in three groups. The diagnostic values of three indexes in pediatric bacterial infections were analyzed by receiver operator characteristic curve(ROC)and the correlation analyses were conducted. Results The HBP,PCT and hs-CRP levels in bacterial infection group were higher than those in viral infection group and healthy group(P<0.01). The areas under ROC curves of HBP,PCT,hs-CRP were 0.902, 0.861 and 0.809,the cut off value were 8.34μg/L,0.55μg/L and 16.48 mg/L with sensitivity of 76.0%,80.0%,76.0% and specificity of 92.0%, 80.0%,80.0%. And the sensitivity,specificity were 76.0%,100.0% for combined with HBP, PCT and hs-CRP. The serum HBP was significant positively correlated with PCT and hs-CRP in children with bacterial infections(P<0.01),while serum PCT was significant positively correlated with hs-CRP(P<0.01). Conclusion Serum HBP,PCT and hs-CRP are indentified as sensitive markers of bacterial infection. The diagnostic value of HBP is better than PCT and hs-CRP. The combined detection of three indicators can improve the specificity and reduce the misdiagnose rate.
展开▼
