2022 年第 12 期 第 17 卷

血清球蛋白和白细胞计数及高敏C反应蛋白检测对小儿脓毒症的诊断价值

Diagnostic value of serum globulin, white blood cell count and high-sensitivity C-reactive protein in children with sepsis

作者：胡元慧 汤冬玲 张平安

英文作者：Hu Yuanhui Tang Dongling Zhang Ping′an

单位：武汉大学人民医院检验科，武汉430060

英文单位：Department of Clinical Laboratory Renmin Hospital of Wuhan University Wuhan 430060 China

关键词：脓毒症；血清球蛋白；白细胞计数；高敏C反应蛋白

英文关键词：Sepsis;Serumglobulin;Whitebloodcellcount;High-sensitivityC-reactiveprotein

• 摘要：

• 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。

• Objective  To explore the diagnostic value of serum globulin, white blood cell count(WBC) and high-sensitivity C-reactive protein(hs-CRP) in children with sepsis. Methods  Clinical data of 112 children with sepsis(sepsis group) and 133 children with common infection(control group) admitted to Renmin Hospital of Wuhan University from July 2020 to June 2022 were collected to retrospective analysis. The pathogenic infection data were collected and statistically analyzed. Venous blood was collected within 24 h after admission the serum was isolated, and the levels of globulin, WBC and hs-CRP were measured and compared. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of single or combined detection of globulin, WBC and hs-CRP in children with sepsis. Results  There were no significant differences in gender and age between the two groups(both P>0.05). The distribution of pathogens was significantly different between the two groups(P<0.05). Among children with single infection, mycoplasma infection rate was the highest［25.5%(12/47) in the control group, 48.6%(17/35) in the sepsis group］, and rhinovirus infection rate was the highest in the mixed infection［42.2%(19/45) in the control group, 34.8%(8/23) in the sepsis group］. Levels of globulin, WBC and hs-CRP in the sepsis group were higher than those in the control group［(21±4) g/L vs (20±3) g/L, 8.6(6.0,13.1)×109/L vs 7.7(5.9,9.9)×109/L, 40.1(23.0,86.2)mg/L vs 5.2(0.6,24.2)mg/L］(all P<0.05). ROC curve analysis showed that the area under the curve of globulin, WBC and hs-CRP combined detection in diagnosing sepsis was 0.853, the sensitivity was 73.24%, the specificity was 87.88%, and the Yoden index was 0.611, which were higher than those of each index detected alone(P<0.05). Conclusion  The combined detection of globulin, WBC and hs-CRP can improve the diagnostic efficiency to pediatric sepsis and has high clinical value.