Barati Leila, Safaeian Baranak, Mehrjerdian Mahshid, Vakili Mohammad-Ali
Neonatal and Children's Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
J Renal Inj Prev. 2016 May 28;5(3):108-11. doi: 10.15171/jrip.2016.23. eCollection 2016.
Urinary tract infection (UTI) is one of the most common bacterial infections in children that can be associated with renal parenchymal injuries and late scars. Dimercaptosuccinic acid (DMSA) renal scan is known as golden standard for detecting acute pyelonephritis (APN) that has a lot of difficulties and limitations.
we designed this study the accuracy of one inflammatory marker, serum procalcitonin (PCT) to identify as an early predictor of renal injuries.
A prospective study was carried out in 95 patients who admitted in the hospital with the first febrile UTI. Serum PCT of all patients was measured; sensitivity, specificity, positive and negative predictive value (PPV and NPV) of this marker was analyzed compared to DMSA scan. P value <0.05 was taken as significant.
In total, 79 females and 16 males were investigated. There are 42 cases in group 1 with normal DMSA scan and 53 patients in group two with renal parenchymal injuries in their scans. Mann-Whitney test showed a meaningful relation between the two groups regarding PCT level (P<0.0001). Sensitivity, specificity, PPV and NPV of PCT reported in optimum cut off were 70%, 88.1%, 88.1% and 70%, respectively. The positive likelihood ratio (PLR) of PCT test was 5.8.
In the current survey, PCT was the eligible inflammatory marker to predict renal parenchymal injuries in children with proper sensitivity, specificity, PPV and NPV that play also a pivotal role in the children aged less than 24 months, although, more studies should be undertaken to confirm.
尿路感染（UTI）是儿童中最常见的细菌感染之一，可能与肾实质损伤及后期瘢痕形成有关。二巯基丁二酸（DMSA）肾扫描是检测急性肾盂肾炎（APN）的金标准，但该检查存在诸多困难和局限性。
我们开展本研究以评估一种炎症标志物——血清降钙素原（PCT）作为肾损伤早期预测指标的准确性。
对95例因首次发热性UTI入院的患者进行了一项前瞻性研究。检测了所有患者的血清PCT；将该标志物的敏感性、特异性、阳性和阴性预测值（PPV和NPV）与DMSA扫描结果进行比较分析。P值<0.05被视为具有统计学意义。
共调查了79名女性和16名男性。第1组有42例DMSA扫描正常，第2组有53例扫描显示有肾实质损伤。曼-惠特尼检验显示两组在PCT水平方面存在显著相关性（P<0.0001）。在最佳截断值时，PCT的敏感性、特异性、PPV和NPV分别为70%、88.1%、88.1%和70%。PCT检测的阳性似然比（PLR）为5.8。
在当前的研究中，PCT是预测儿童肾实质损伤的合适炎症标志物，具有适当的敏感性、特异性、PPV和NPV，在24个月以下儿童中也起着关键作用，不过，仍需更多研究加以证实。
