Diagnostic Study On Acute Invasive Bacterial Diarrhea In Children By Constructing A Joint Scoring System With Parameters Of C-reactive Protein And Procalcitonin

Objective:Constructing a joint scoring system with the parameters of serum C-reactive protein(CRP)and procalcitonin(PCT),which is to explore the diagnostic value of acute invasive bacterial diarrhea in children.Methods:(1)Clinical cases:a comparative study of children with diarrhea treated in our department from August 2016 to August 2017,including 72 cases of invasive bacterial diarrhea and 69 cases of non-bacterial diarrhea.(2)study methods:The PCT and CRP levels of the two groups of children were compared to explore the diagnostic value of the single index.And the Binary Logistic regression analysis was further constructed to explore the correlation between the indexes and invasive bacterial diarrhea.Then according to the parameters and regression coefficients,the joint scoring system of the two indexes was constructed.Further,the diagnostic value of the joint scoring system was verified by comparing the area,sensitivity and specificity under the ROC curve of the three indexes.Results:(1)there was no significant difference in age,sex and other baseline data between the two groups(P>0.05).The 72 cases of invasive bacterial diarrhea included 7 cases of Shigella infection(9.72%),59 cases of Salmonella infection(81.94%),2 cases of Pseudomonas aeruginosa(2.78%),and 4 cases of Escherichia coll(5.56%).(2)the levels of CRP and PCT in the children with invasive bacterial diarrhea were significantly higher than those in the non-bacterial diarrhea group,and the difference was statistically significant(P<0.05).(3)The Binary Logistic regression analysis confirmed that there was a significant correlation between the levels of CRP&PCT and invasive bacterial diarrhea(P<0.05).According to the parameters and regression coefficients of the two indexes,the formula for constructing the joint score is Logit(joint score)=-1.83+1.16xPCT+0.05xCRP.(4)Through constructing the ROC curves of the joint score,CRP and PCT,the AUC area of the joint scoring system was 0.894,CRP was 0.801,PCT was 0.812,and the joint score was significantly greater than CRP and PCT,and the difference was statistically significant(P<0.05).(5)the diagnostic boundary value of the three indexes was intercepted on the principle of maximum Youden index,in which the best diagnostic value was 14.4 mg/L,PCT was 1.24 ng/mL,and the joint score was 0.52,and to calculate the sensitivity and specificity of the three indexes.As a reslut,the sensitivity and specificity of the joint score were significantly higher than those of CRP and PCT(P<0.05).Conclusion:In children with invasive bacterial diarrhea,serum CRP and PCT have good diagnostic reference value,and the joint scoring system based on the two indexes can further improve the accuracy of diagnosis,which is better than the single index.