摘要
目的探讨C反应蛋白(CRP)在婴儿泌尿系感染诊断中的价值。方法回顾分析2015年1月1日至2017年12月31日儿科门诊以发热为首发症状就诊的婴儿,病初有血常规和CRP检查结果且CRP>8 mg·L^-1者,最终诊断明确为细菌感染者(包括呼吸道感染、消化道感染、泌尿系感染和中枢神经系统感染),根据CRP(mg·L^-1)数值分为A组(8~25)、B组(25~50)、C组(50~75)、D组(75~100)和E组(≥100),比较不同组的诊断情况。结果713例婴儿纳入研究,其中A、B、C、D和E组分别为320、216、84、58和35例。随着CRP的升高,泌尿系感染所占比例升高,而呼吸道感染和消化道感染所占比例降低。当CRP≥50 mg·L^-1时,泌尿系感染阳性率62.1%(110/177);当CRP≥75 mg·L^-1时,泌尿系感染阳性率87.1%(81/93);而当CRP≥100 mg·L^-1时,泌尿系感染阳性率高达91.4%(32/35)。当CRP≥50 mg·L^-1时,约登指数最大(0.819),敏感度93.2%(95%CI:86.6%~96.8%),特异度88.7%(95%CI:85.9%~91.1%)。结论凡是婴儿发热,特别是血常规CRP明显升高者(≥50 mg·L^-1),在应用抗生素之前必须完善尿常规检查,以明确或除外泌尿系感染可能。
Objective To explore the diagnostic value of C reactive protein(CRP)on urinary tract infections(UTI)in infants.Methods According to the level of CRP,the clinical data of outpatient infants with fever,who were first visited in our hospital from January,2015 to December,2017 were studied retrospectively.They were diagnosed clearly and divided into five groups including A(CRP<25 mg·L^-1)、B(25≤CRP<50 mg·L^-1)、C(50≤CRP<75 mg·L^-1)、D(75≤CRP<100 mg·L^-1)and E(CRP≥100 mg·L^-1),respectively.Results 713 cases of infants with fever were included finally in the study,and group A,B,C,D and E consist of 320,216,84,58 and 35,respectively.With the level of CRP increasing,the percent of UTI also increased.When CRP≥50 mg·L^-1,≥75 mg·L^-1 and≥100 mg·L^-1,the percent of UTI was 62.1%(110/177),87.1%(81/93)and 91.4%(32/35),respectively.When CRP≥50 mg·L^-1,Youden index was the most with 93.2%sensitivity(95%CI:86.6% 96.8%)and 88.7%specificity(95%CI:85.9% 91.1%)Conclusion Routine urianalysis must be down in order to exclude or identify the diagnosis of UTI in infants with unknown fever and obviously increased CRP(≥50 mg·L^-1).
作者
王利霞
马丽娟
张宏文
WANG Li-xia;MA Li-juan;ZHANG Hong-wen(Department of Pediatric,Peking University First Hospital,Beijing 100034;Department of Pediatric,Ningxia Maternal and Child Health Care Hospital&Ningxia Children's Hospital,Yinchuan 750011)
出处
《中国循证儿科杂志》
CSCD
北大核心
2019年第6期457-459,共3页
Chinese Journal of Evidence Based Pediatrics
关键词
婴儿
CRP
泌尿系感染
诊断价值
Infant
C reactive protein
Urinary tract infections
Diagnostic value
