Martínez L Ana Belén, Marañón P Rafael, Cobo E Pilar Virginia, Tomatis S Cristina, Guerra M Luis, Peñalba C Ana Cristina
Rev Chil Pediatr. 2014 Apr;85(2):157-63. doi: 10.4067/S0370-41062014000200004.
There is no hematological marker that reliably differentiates between bacterial and nonbacterial acute gastroenteritis (AGE). The objective of this study is to evaluate procalcitonin (PCT) as a marker for bacterial AGE and analyze its relationship with hospital admission.
A prospective study of children diagnosed with AGE was conducted at the emergency room during a period of seven months, which required blood and stool samples. Epidemiological, clinical and analytical variables were analyzed. Patients with chronic digestive disease, prolonged diarrhea, immunodeficiency or prior antibiotic treatment were excluded. The study was approved by the Ethics Committee and an informed consent was requested.
45 patients were analyzed. Children with bacterial GEA were older (p=0.027) and presented higher median PCT and C-reactive protein concentrations (CRP) (p=0.001). The PCT and CRP values that best discriminated bacterial infection were PCT≥0.05 mg/L (sensibility 64.3%, specificity 83.9%, positive probability coefficient (PPC): 4), and CRP≥3 mg/dL (sensibility 78.6%, specificity 90.3%, PPC: 8). No association between the elevation of these markers and higher hospitalization probability was found.
Procalcitonin, like CRP, is elevated in bacterial gastroenteritis (p=0.001), but these markers are not a predictor of hospitalization.
目前尚无可靠区分细菌性和非细菌性急性胃肠炎（AGE）的血液学标志物。本研究旨在评估降钙素原（PCT）作为细菌性AGE的标志物，并分析其与住院情况的关系。
在七个月的时间里，对急诊室诊断为AGE的儿童进行了一项前瞻性研究，该研究需要采集血液和粪便样本。分析了流行病学、临床和分析变量。排除患有慢性消化系统疾病、长期腹泻、免疫缺陷或先前接受过抗生素治疗的患者。该研究经伦理委员会批准，并获得了知情同意。
共分析了45例患者。细菌性GEA患儿年龄较大（p = 0.027），降钙素原和C反应蛋白（CRP）的中位数浓度较高（p = 0.001）。最能区分细菌感染的PCT和CRP值分别为PCT≥0.05 mg/L（敏感性64.3%，特异性83.9%，阳性预测值（PPC）：4），以及CRP≥3 mg/dL（敏感性78.6%，特异性90.3%，PPC：8）。未发现这些标志物升高与较高住院概率之间存在关联。
与CRP一样，降钙素原在细菌性胃肠炎中升高（p = 0.001），但这些标志物并非住院的预测指标。
