临床及实验室指标对小儿急性非链球菌性扁桃体咽炎的诊断意义

L. A. Ivanova, I. Horbatiuk, I. Horbatiuk, I. Balaniuk, A. O. Shkilnyuk
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引用次数: 0

摘要

本研究旨在探讨临床及实验室参数在小儿急性非链球菌性扁桃体咽炎诊断中的诊断意义,以确定合理的治疗策略。材料和方法。为了达到这个目的,我们成立了两个临床小组。第一组(主要)为66例非链球菌性急性扁桃体咽炎患者,咽灌洗及咽后壁细菌检查阴性。第二(II)临床组包括32例诊断为“链球菌急性扁桃体咽炎”的儿童。McIsaac量表总分不超过2分,I组15.2±4.4%,对照组为6.2±4.2%。该方法的敏感性为15.2%,特异性为93.7%,阳性预测值和阴性预测值分别为83.3%和34.8%,优势比为2.6 [95% CI: 0.5 ~ 13,0]。第一组患者血液白细胞平均含量低于8.9 × 109/l的比例为57.6%,第二组为48.8% (P > 0.05)。该实验室检测非链球菌性扁桃体咽炎的敏感性为57.6%,特异性为55.6%,阳性预测值为54.1%,阴性预测值为59.1%。当登记的患者外周血白细胞低于8.9 × 109/l时,atp非链球菌病因的相对风险为1.7 (95% CI 0.9-2.9),绝对风险为- 0.1,优势比为1.7 (95% CI 0.9-2.9)。所提出的临床量表及部分临床旁参数的诊断价值不足,不能独立用于儿童扁桃体咽炎非链球菌病原学的早期验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
DIAGNOSTIC SIGNIFICANCE OF CLINICAL AND LABORATORY INDICES IN VERIFICATION OF ACUTE NON-STREPTOCOCCAL TONSYLOPHARYNGITIS IN CHILDREN
The aim of the study - to study the diagnostic significance of clinical and laboratoryparameters in the verification of acute non-streptococcal tonsillopharyngitis in childrenin order to determine rational treatment tactics.Material and methods. To achieve this aim, two clinical groups were formed. The first (I,main) group consisted of 66 patients with acute tonsillopharyngitis of non-streptococcaletiology, as evidenced by the negative result of bacterial examination of the lavage ofthe pharynx and posterior pharyngeal wall. The second (II) clinical group included 32children diagnosed with "streptococcal acute tonsillopharyngitis".Results. The total score on the McIsaac scale, which did not exceed 2 points, wasregistered in 15.2 ± 4.4% of group I patients and 6.2 ± 4.2% of patients in the comparisongroup. The sensitivity of the method was 15.2%, specificity – 93.7%, positive and negativepredicted value – 83.3% and 34.8%, respectively, with odds ratio – 2.6 [95% CI: 0.5-13,0]. The average content of leukocytes in the blood less than 8.9 × 109/l was registeredin 57.6% of patients of group I and 48.8% of representatives of the second (P˃0.05). Thesensitivity of this laboratory test in the detection of non-streptococcal tonsillopharyngitiswas 57.6%, specificity – 55.6%, predicted value of a positive result – 54.1%, predictedvalue of a negative result – 59.1%. The relative risk of non-streptococcal etiology of ATPwhen registering a patient with less than 8.9 × 109/l of peripheral blood leukocytes was1.7 (95% CI 0.9-2.9), the absolute risk – 0.1 with odds ratio of 1.7 (95% CI 0.9-2.9).Conclusions. The proposed clinical scales and some paraclinical parameters haveinsufficient diagnostic value, so they cannot be used independently for early verificationof non-streptococcal etiology of tonsillopharyngitis in children.
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