Value of procalcitonin, C-reactive protein and white blood cell count in combination in the differential diagnosis of different types of infantile enteritis / 中国基层医药

ABSTRACT

Objective:To investigate the significance of procalcitonin (PCT), C-reactive protein (CRP) and white blood cell count (WBC) in the differential diagnosis of bacterial enteritis and viral enteritis in children.Methods:The clinical data of 84 children with enteritis who received treatment in General Hospital of Taiyuan Iron and Steel (Group) Co. Ltd., China were retrospectively analyzed. Among these children, 47 suffered from bacterial enteritis (bacterial enteritis group) and 37 suffered from viral enteritis (viral enteritis group). PCT, CRP and WBC were determined and compared between the bacterial enteritis and viral enteritis groups. The outcomes and efficacy of PCT, CRP and WBC alone and in combination in the diagnosis of bacterial enteritis in children were determined.Results:PCT and CRP levels and WBC in the bacterial enteritis group were significantly higher than those in the viral enteritis group ( t = 12.427, 15.219, 10.912, all P < 0.05). The proportion of abnormal PCT and CRP levels and WBC in the bacterial enteritis group was 53.19%, 46.81% and 42.55%, which were significantly higher than those in the viral enteritis group (13.51%, 8.11%, 8.11%, χ2 = 14.195, 14.832, 12.353, all P < 0.05). The sensitivity, specificity, accuracy, missed diagnosis rate and misdiagnosis rate of PCT were 53.19%, 86.49%, 67.86%, 46.81% and 13.51% respectively, while they were 46.81%, 91.89%, 66.67%, 53.19% and 8.11% respectively for CRP and 42.55%, 91.89%, 64.29%, 57.45% and 8.11% respectively for WBC. The sensitivity, specificity, accuracy, missed diagnosis rate and misdiagnosis rate for PCT, CRP and WBC in combination were 87.23%, 94.59%, 90.48%, 12.77% and 5.41% respectively. The accuracy ( χ2 = 13.028, 14.141, 16.459) and sensitivity ( χ2 = 13.021, 17.375, 10.593) of PCT, CRP and WBC in combination were significantly higher than those of PCT, CRP and WBC alone in the diagnosis of bacterial enteritis in children (all P < 0.05). The missed diagnosis rate of PCT, CRP and WBC in combination was significantly lower than that of PCT, CRP and WBC alone in the diagnosis of bacterial enteritis in children ( χ2 = 13.021, 17.375, 10.593, all P < 0.05). There were no significant differences in specificity and misdiagnosis rate between PCT, CRP and WBC in combination and alone ( χ2 = 1.420, 0.000, 0.000, all P > 0.05). Conclusion:PCT, CRP and WBC in combination can effectively distinguish bacterial enteritis from viral enteritis in children, with highly reliable diagnosis results. Therefore, this detection method is of important clinical application value.