vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v15i1.1502vsp-1584Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESДиагностическая значимость показателей гемограммы и сывороточных маркеров воспаления при тяжелых бактериальных инфекциях у детей младше 5 летThe Diagnostic Significance of Hemogram Indicators and Serum Markers of Inflammation in Serious Bacterial Infections in Children Under 5 Years of AgeМельничукО. С.MelnichukO. S.

кандидат медицинских наук, старший научный сотрудник лаборатории экспериментальной иммунологии и вирусологии,

119991, Москва, Ломоносовский проспект, д. 2, стр. 1

Moscow

melnichuk@nczd.ruКуличенкоТ. В.KulichenkoT. V.

Москва

Moscow

МаянскийН. А.MayanskiyN. A.

Москва

Moscow

МалаховаА. Е.MalakhovaA. Ye.

Москва

Moscow

Научный центр здоровья детейРоссияScientific Center of Children’s HealthRussian Federation2016240220161517481Copyright © Мельничук О.С., Куличенко Т.В., Маянский Н.А., Малахова А.Е., 20162016Мельничук О.С., Куличенко Т.В., Маянский Н.А., Малахова А.Е.Melnichuk O.S., Kulichenko T.V., Mayanskiy N.A., Malakhova A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/1584

Диагностика тяжелых бактериальных инфекций (ТБИ) у детей младшего возраста остается трудной задачей.

Цель исследования

Цель исследования: установить закономерности изменения показателей гемограммы и сывороточных маркеров воспаления для дифференциальной диагностики ТБИ у детей в возрасте до 5 лет.

Методы

Методы: проведено сравнительное ретроспективное исследование. Проанализированы диагностические характеристики лабораторных маркеров ТБИ при обследовании 306 детей с фебрильной лихорадкой. В крови определяли число лейкоцитов, нейтрофилов, незрелых гранулоцитов, эквивалент содержания гемоглобина в ретикулоцитах, С-реактивный белок (СРБ) и прокальцитонин.

Результаты

Результаты: наибольшей диагностической точностью при дифференциальной диагностике ТБИ у детей с инфекционной лихорадкой в разгар заболевания обладает исследование содержания СРБ. Установлено, что положительный результат СРБ ( 37 мг/л) повышает вероятность ТБИ у пациента с 17,6 до 70%, а отрицательный (< 37 мг/л) — снижает вероятность ТБИ до 4%.

Заключение

Заключение: пороговые значения (cut-off) лабораторных показателей, полученные в настоящей работе, могут быть использованы при оценке посттестовой вероятности ТБИ у детей с инфекциями, сопровождающимися фебрильной лихорадкой.

Background

Background: Diagnosis of serious bacterial infections (SBI) in young children is a difficult task for pediatricians.

Objective

Objective: Our aim was to determine regularities of the change of hemogram indicators and serum markers of inflammation for the differential diagnostics of SBI in children under the age of 5 years.

Methods

Methods: The comparative retrospective study is carried out. We analyzed diagnostic characteristics of laboratory markers of SBI during the examination of 306 children with pyretic fever. We determined the number of leukocytes, neutrophils, immature granulocytes, reticulocyte hemoglobin equivalent, C-reactive protein (CRP) and procalcitonin.

Results

Results: The study of CRP content has the greatest diagnostic accuracy at differential diagnostics of SBI in children with infectious fever at the height of disease. It is established that the positive result of CRP ( 37 mg/L) increases the probability of SBI in patient from 17.6% to 70%, and the negative result (< 37 mg/L) reduces the probability of SBI to 4%.

Conclusion

Conclusion: Cut-off values of the laboratory parameters obtained in our study can be used when assessing the post-test probability of SBI in children with infections accompanied by pyretic fever.

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The authors declare that there are no conflicts of interest present.