血清炎症因子在评估儿童社区获得性肺炎病情严重程度中的临床价值  

Clinical value of serum inflammatory cytokines in the assessment of the severity of children with community acquired pneumonia

作　　者：倪金凤[1] 高长俊[1] 郝冬荣[1] 张慧玉[1] 田庆玲[1] 冯雪[1] 

机构地区：[1]河北省唐山市妇幼保健院儿科,河北唐山063000

出　　处：《中国医药导报》2016年第4期69-72,共4页China Medical Herald

摘　　要：目的探讨血清炎症因子C-反应蛋白（CRP）、血清降钙素原（PCT）、白细胞计数（WBC）、中性粒细胞计数（NUET）在预测儿童社区获得性肺炎（CAP）病情时的应用价值。方法选取2014年1月～2015年8月在河北省唐山市妇幼保健院进行治疗的CAP患儿136例作为研究对象,包括喘息性CAP组（81例）和非喘息性CAP组（55例）,另选取健康儿童40名为对照组。检测并比较CRP、PCT、WBC、NUET及免疫因子白介素4（IL-4）、白介素10（IL-10）的水平,采用受试者工作曲线（ROC）分析血清炎症因子对CAP的诊断价值。结果喘息性CAP组的CRP、PCT、WBC、NEUT等指标水平均明显高于对照组及非喘息性CAP组（P〈0.05）,非喘息性CAP组的CRP、PCT、WBC水平明显高于对照组（P〈0.05）;喘息性CAP组的IL-4、IL-10水平均明显高于对照组及非喘息性CAP组（P〈0.05）,非喘息性CAP组的IL-4、IL-10水平明显高于对照组（P〈0.05）。CRP、PCT、WBC、NEUT4中血清炎症因子诊断CAP的ROC曲线下面积分别为0.7749（95%CI：0.7052～0.8446）、0.9589（95%CI：0.9376～0.9802）、0.7528（95%CI：0.6854～0.8203）、0.6311（95%CI：0.5317～0.7205）（P〈0.05）,PCT诊断CAP的灵敏度及特异度最高。CRP、PCT、WBC、NEUT4中血清炎症因子诊断喘息性CAP及非喘息性CAP的ROC曲线下面积分别为0.9454（95%CI：0.9080～0.9829）、0.7927（95%CI：0.7182～0.8672）、0.7760（95%CI：0.6967～0.8552）、0.7423（95%CI：0.6599～0.8247）（P〈0.05）,CRP诊断喘息性CAP及非喘息性CAP的灵敏度及特异度最高。结论 CRP及PCT两种指标有利于诊断儿童喘息性及非喘息性CAP。[Abstract] Objective To investigate the clinical value of serum inflammatory cytokines such as C-reactive protein （CRP）, serum proealeitonin （PCT）, white blood cell count （WBC）, neutrophil count （NUET） in the assessment of the severity of children with community acquired pneumonia （CAP）. Methods One hundred and thirty six children with CAP treated in Maternal and Child Care Service Center of Tangshan City from January 2014 to August 2015 were se- lected as research objects, including asthmatic CAP group （n = 81） and non-asthmatic CAP group （n = 55）, and 40 healthy children were taken as control group. The levels of CRP, PCT, WBC, NUET and immune factors interleukins 4 （IL-4）, interleukin 10 （IL-10） were detected and compared. ROC curve analysis was used to analyze the diagnostic val- ue of serum inflammatory factors for CAP. Results The levels of CRP, PCT, WBC, NEUT of asthmatic CAP group were significantly higher than those of control group and non-asthmatic CAP group （P 〈 0.05）, the levels of CRP, PCT, WBC of non-asthmatic CAP group were significantly higher than those of control group （/9 〈 0.05）; the levels of IL-4, IL-10 of asthmatic CAP group were significantly higher than those of control group and non-asthmatic CAP group （P 〈 0.05）, the levels of IL-4, IL-10 of non-asthmatic CAP group were significantly higher than those of control group （P 〈 0.05）. The area under the ROC curve of CRP, PCT, WBC, NEUT4 in diagnosis of CAP were 0.7749 （95%CI： 0.7052-0.8446）, 0.9589 （95%CI： 0.9376-0.9802）, 0.7528 （95%CI： 0.6854-0.8203）, 0.6311 （95%CI： 0.5317-0.7205） （P 〈 0.05）, the sensitivity and specificity of PCT in diagnosis of CAP was the highest. The area under the ROC curve of CRP,PCT, WBC, NEUT4 in diagnosis of asthmatic CAP and non-asthmatic CAP were 0.9454 （95%CI： 0.9080-0.9829）, 0.7927 （95%CI： 0.7182-0.8672）, 0.7760 （95%CI： 0.6967-0.8552）, 0.7423 （95%CI： 0.6599-0.8247） （P 〈 0.05）, the sensi- tivi

关 键 词：儿童 社区获得性肺炎 降钙素原 C-反应蛋白 诊断价值 

分 类 号：R563.1[医药卫生—呼吸系统]