| Objective-To evaluate the clinical significance of Procalcitonin (PCT), discussing that whether the PCT is still of higher sensitivity and specificity in the diagnosis of bacterial infection of children nephritic syndrome individual or not. And Whether it has important significance for guiding the application of antibiotics.Methods:Analysis from October2011to December2012were recurrence or drug resistance of92cases of children with primary nephritic syndrome, by detecting leukocyte count, neutrophil percentage, CRP, ESR, PCT, such as inflammatory indexes and the chest X-ray film, pathogen detection, blood culture; if it is necessary, we need to do sputum culture,even urine culture and so on. At the same time combining with the clinical manifestations, these92cases were divided into2groups:NS relaps group (45cases) and NS with infection group (47cases); then according to the results of pathogen detection, the NS with infection group was divided into NS with bacterial infection group (28cases) and NS merging non-bacterial infection group (19cases). Then comparing to the WBC, N, CRP, ESR, PCT between groups, and within the same group of CRP and PCT, detecting the sensitivity, specificity, positive predictive value and the negative predictive value, observing its diagnostic sensitivity and specificity for bacterial infections, and whether of the guidance of the application of antibiotics in clinic. A relevant database was established with EXCEL2003and the data were analyzed with SPSS18.0software.Results:In group NS recurrence and NS with the infection, the comparison between CRP and PCT values between the two groups has significant difference, P values were less than0.05, the difference was of statistical significance, and the both can be used as diagnostic indicators of bacterial infection; the leukocyte count and neutrophil percentage and ESR have no obvious difference. In NS with infection group, serum PCT test for bacterial infection diagnostic sensitivity was35.7%(10/28), the specificity was78.9%(15/19), the positive predictive value was71.4%(10/14), the negative predictive value was45.5%(15/33); and the sensitivity of CRP was64.3%(18/28), the specificity was94.7%(18/19), the positive predictive value was94.7%(18/19), the negative predictive value was64.5%(18/28). The results suggest that in NS with infection group the diagnostic sensitivity and specificity of CRP were higher than PCT. However, in NS merging bacterial infection group, with CRP and PCT two kinds of different detection methods to the sensitivity of the diagnostic of bacterial infection, has P value0.0287(P<0.05), the difference has obvious statistical significance. This suggests that in NS individual CRP and PCT are still the sensitive index of the diagnosis of bacteria infection, but the sensitivity of CRP is higher than PCT, they can both be widely used in clinic. In NS relaps group, it was found that ESR and24hours urine protein quantitative has certain relevance; with the increase of24hours urinary protein quantitative, ESR has the tendency of the rise; but in NS merging infection ESR can rise, too. This suggests ESR is associated with disease activity and infection, it is not of specificity.Conclusions:1. In identification of NS merging bacterial infection, the sensitivity and specificity of CRP is higher than that of PCT.2. In determination whether NS is accompanied by bacterial infection or not, the diagnostic sensitivity of PCT and CRP is superior to other traditional inflammatory indicators, the comparative difference between groups has obvious statistical significance, and both can be used as diagnostic indicators of bacterial infection.3. ESR is associated with disease activity, with24hours urine protein quantitative has certain relevance, but no specificity. |
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