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降钙素原和胰腺结石蛋白在小儿急性骨髓炎的早期诊断中作为生物标志物的作用。

Procalcitonin and Pancreatic Stone Protein Function as Biomarkers in Early Diagnosis of Pediatric Acute Osteomyelitis.

机构信息

Department of Integrated Traditional Chinese and Western Medicine, Tianjin Hospital, Tianjin, China (mainland).

出版信息

Med Sci Monit. 2017 Nov 1;23:5211-5217. doi: 10.12659/msm.904276.

DOI:10.12659/msm.904276
PMID:29091592
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5678429/
Abstract

BACKGROUND High plasma levels of procalcitonin (PCT) are typically seen in children with severe bacterial infection, particularly in cases of septic shock or bacteremia. Similarly, pancreatic stone protein (PSP) is associated with inflammation, infection, and other disease-related stimuli. However, the prognostic value of PSP in critically ill pediatric patients is unknown. This study investigated the early diagnostic value of PCT and PSP in pediatric acute osteomyelitis. MATERIAL AND METHODS A total of 187 patients with suspected acute osteomyelitis and 80 healthy control children were enrolled. The serum expression of PTC and PSP was measured. Pearson correlation analysis was conducted to correlate PTC with PSP. ROC analysis was used to test the value of PTC and PSP in early diagnosis of pediatric acute osteomyelitis. RESULTS Acute osteomyelitis was diagnosed in 49.2% of the patients (n=92) based on the layered bone puncture. The serum levels of PTC and PSP in pediatric acute osteomyelitis were higher than in the non-acute osteomyelitis group (P<0.01). Serum PTC concentrations showed a significantly positive correlation with PSP levels (P<0.001). ROC analysis showed that the AUC values of PTC and PSP were 0.767 (95% CI, 0.700-0.826), and 0.796 (95% CI, 0.731-0.855), respectively. The AUC value of PTC & PSP was 0.903 (95% CI: 0.851-0.941), which was markedly increased compared with PTC or PSP (P<0.01). CONCLUSIONS Serum levels of PCT and PSP are promising biomarkers for early diagnosis of pediatric acute osteomyelitis.

摘要

背景

降钙素原(PCT)在患有严重细菌感染的儿童中通常表现为高血浆水平,尤其是在脓毒性休克或菌血症的情况下。同样,胰腺石蛋白(PSP)与炎症、感染和其他与疾病相关的刺激有关。然而,PSP 在危重症儿科患者中的预后价值尚不清楚。本研究旨在探讨 PCT 和 PSP 在儿科急性骨髓炎中的早期诊断价值。

材料和方法

共纳入 187 例疑似急性骨髓炎患儿和 80 例健康对照儿童。检测血清 PCT 和 PSP 的表达水平。采用 Pearson 相关分析来评估 PCT 与 PSP 之间的相关性。采用 ROC 分析来检验 PCT 和 PSP 在儿科急性骨髓炎早期诊断中的价值。

结果

根据分层骨穿刺,49.2%(92 例)的患者被诊断为急性骨髓炎。与非急性骨髓炎组相比,急性骨髓炎患儿的血清 PCT 和 PSP 水平更高(P<0.01)。PCT 与 PSP 之间呈显著正相关(P<0.001)。ROC 分析显示,PTC 和 PSP 的 AUC 值分别为 0.767(95%CI:0.700-0.826)和 0.796(95%CI:0.731-0.855)。PTC&PSP 的 AUC 值为 0.903(95%CI:0.851-0.941),与 PCT 或 PSP 相比明显增加(P<0.01)。

结论

血清 PCT 和 PSP 水平是儿科急性骨髓炎早期诊断的有前途的生物标志物。

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