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粪便钙卫蛋白联合降钙素原在儿童细菌性与病毒性腹泻鉴别诊断中的价值

The Value of Fecal Calprotectin Combined with Procalcitonin in the Differential Diagnosis of Bacterial and Viral Diarrhea in Children.

作者信息

Guo Qi, Guo Hui, Xu Xia

机构信息

Department of Pediatrics, Anhui No.2 Provincial People's Hospital, Hefei, China.

Anhui Province Maternity & Child Health Hospital, Hefei, China.

出版信息

Am J Trop Med Hyg. 2025 Mar 4;112(5):1060-1064. doi: 10.4269/ajtmh.24-0458. Print 2025 May 7.

Abstract

Infectious diarrhea frequently occurs in children, and accurate diagnosis is essential for providing prompt treatment. Fecal calprotectin (FC) and procalcitonin (PCT) are useful in differentiating types of infectious diarrhea. Therefore, this study aims to assess the value of combining FC and PCT in the differential diagnosis of bacterial and viral diarrhea in children. As a retrospective study, convenience sampling was used to include 60 children with acute bacterial diarrhea (bacterial group) and 70 children with acute viral diarrhea (viral group) who were admitted to hospitals in China between October 2019 and October 2021. The demographic characteristics, medical history, and laboratory data of the children were collected and compared. The proportions of children with myocardial and liver damage were lower in the bacterial group than in the viral group, and the proportions of children with bloody stool and purulent stool were higher in the bacterial group than in the viral group (all P <0.001). The levels of FC, PCT, C-reactive protein (CRP), and white blood cells (WBCs) were elevated in patients in the bacterial group compared with those in the viral group (all P <0.05). The FC, PCT, CRP, and WBC count values are valuable in the differential diagnosis of bacterial and viral diarrhea, and the area under the curve of FC combined with PCT for the differential diagnosis was the largest at 0.933, with a 95% CI of 0.856-0.955. Fecal calprotectin is superior to PCT, CRP, and WBC count in terms of guiding the differential diagnosis. The combination of FC and PCT provides better guidance for differential diagnosis than each indicator used individually.

摘要

感染性腹泻在儿童中频繁发生,准确诊断对于及时治疗至关重要。粪便钙卫蛋白(FC)和降钙素原(PCT)有助于鉴别感染性腹泻的类型。因此,本研究旨在评估联合FC和PCT在儿童细菌性和病毒性腹泻鉴别诊断中的价值。作为一项回顾性研究,采用便利抽样法纳入了2019年10月至2021年10月期间在中国住院的60例急性细菌性腹泻儿童(细菌组)和70例急性病毒性腹泻儿童(病毒组)。收集并比较了儿童的人口统计学特征、病史和实验室数据。细菌组心肌和肝损伤儿童的比例低于病毒组,细菌组血便和脓便儿童的比例高于病毒组(均P<0.001)。与病毒组相比,细菌组患者的FC、PCT、C反应蛋白(CRP)和白细胞(WBC)水平升高(均P<0.05)。FC、PCT、CRP和WBC计数在细菌性和病毒性腹泻的鉴别诊断中具有价值,FC联合PCT鉴别诊断的曲线下面积最大,为0.933,95%CI为0.856-0.955。在指导鉴别诊断方面,粪便钙卫蛋白优于PCT、CRP和WBC计数。FC和PCT联合应用比单独使用每个指标在鉴别诊断中提供更好的指导。

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