摘要
目的 探讨血液C反应蛋白(CRP)、淀粉样蛋白A(SAA)、白细胞介素-6(IL-6)、白细胞计数(WBC)联合检测在小儿细菌性肺炎诊断中的应用价值及临床意义。方法 选取我院2020年6月至2022年7月收治的45例细菌性肺炎患儿为细菌组,同期45例病毒性肺炎患儿为病毒组,根据入院时小儿危重症病例评分(PCIS)将细菌性肺炎患儿分为重症(17例,PCIS评分<80分)和轻症(28例,PCIS评分≥80分)两个亚组。比较两组入院时CRP、SAA、IL-6、WBC水平,比较重症、轻症患儿入院时CRP、SAA、IL-6、WBC水平,分析入院时CRP、SAA、IL-6、WBC水平与PCIS评分相关性,ROC分析CRP、SAA、IL-6、WBC联合检测对细菌性肺炎的诊断价值。结果 与病毒组相比,入院时细菌组血液CRP、SAA、IL-6、WBC水平较高(P <0.05);入院时重症细菌性肺炎患儿血液CRP、SAA、IL-6、WBC水平高于轻症患儿(P <0.05);入院时血液CRP、SAA、IL-6、WBC水平与PCIS评分均呈负相关(r=-0.684、-0.705、-0.591、-0.633,P <0.05);血液CRP、SAA、IL-6、WBC水平联合诊断细菌性肺炎的AUC为0.887,敏感度、特异度分别为86.67%、91.11%。结论 血液CRP、SAA、IL-6、WBC水平与小儿细菌性肺炎病情程度存在紧密联系,具有较高诊断价值,有利于临床早期鉴别诊断小儿肺炎感染类型,为临床早期肺炎感染原鉴别诊断提供可靠依据,以针对性制订相应干预方案,改善预后。
Objective To explore the value and clinical significance of combined detection of C-reactive protein(CRP), amyloid A(SAA),interleukin-6(IL-6) and white blood cell count(WBC) in the diagnosis of bacterial pneumonia in children. Methods 45 children with bacterial pneumonia admitted to our hospital from June 2020 to July 2022 were selected as the bacterial group, and 45 children with viral pneumonia in the same period were selected as the virus group. According to the pediatric critical case score(PCIS) at admission, children with bacterial pneumonia were divided into two subgroups: severe(17 cases, PCIS score<80) and mild(28 cases, PCIS score ≥ 80). The levels of CRP, SAA, IL-6 and WBC at admission were compared between the two groups, and the levels of CRP, SAA, IL-6 and WBC at admission of children with severe and mild diseases were compared. The correlation between the levels of CRP, SAA, IL-6 and WBC at admission and PCIS score was analyzed. The diagnostic value of combined detection of CRP, SAA, IL-6 and WBC for bacterial pneumonia was analyzed by ROC. Results Compared with the virus group,the levels of CRP, SAA, IL-6 and WBC in the blood of the bacterial group were higher(P<0.05). The levels of CRP, SAA, IL-6 and WBC in the blood of children with severe bacterial pneumonia at admission were higher than those of children with mild symptoms(P<0.05). The levels of CRP, SAA, IL-6, WBC in blood at admission were negatively correlated with PCIS scores(r=-0.684,-0.705,-0.591,-0.633, P<0.05). The AUC of combined diagnosis of serum CRP, SAA, IL-6 and WBC levels for bacterial pneumonia was 0.887, the sensitivity and specificity were 86.67%and 91.11% respectively. Conclusion The levels of CRP, SAA, IL-6 and WBC in blood are closely related to the severity of bacterial pneumonia in children, and have high diagnostic value, which is conducive to the early clinical differential diagnosis of the type of pneumonia infection in children, and provides reliable basis for the differential diagnosis of the infectious agent of pneumonia in the early clinical stage, so as to formulate the corresponding intervention plan to improve the prognosis.
作者
尤秀聪
YOU Xiucong(Department of Laboratory,Nan'an Hospital,Fujian Province,Nan'an 362300,China)
出处
《中国医药指南》
2023年第4期102-104,共3页
Guide of China Medicine
