血清hs⁃CRP、TGF⁃β和TLR4水平对儿童急性细菌性肺炎的临床诊断价值  

Clinical diagnostic value of serum hs⁃CRP,TGF⁃βand TLR4 levels in children with acute bacterial pneumonia

作　　者：杨德彬 冯日昇[1] 王玲玲[1] 郭燕军 YANG Debin;FENG Risheng;WANG Lingling;GUO Yanjun(General Internal Medicine Section 2,Affiliated Children's Hospital of Zhengzhou University/Henan Children's Hospital/Zhengzhou Children's Hospital,Zhengzhou,Henan,China,450053)

机构地区：[1]郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院普内科二病区,河南郑州450053

出　　处：《分子诊断与治疗杂志》2020年第2期212-216,共5页Journal of Molecular Diagnostics and Therapy

基　　金：2018年度河南省科技攻关目录(182102311202)。

摘　　要：目的探讨血清hs⁃CRP、TGF⁃β和TLR4水平变化及对儿童急性细菌性肺炎的临床诊断价值。方法选择自2017年8月至2018年9月在本院接受治疗的113例急性细菌性肺炎患儿,作为观察组,同时选择100例体检健康的儿童作为对照组,记录两组的基本临床资料,采用ELISA实验检测两组血清hs⁃CRP、TGF⁃β和TLR4水平。通过多因素Logistic回归分析研究儿童急性细菌性肺炎预后因素。采用绘制受试者工作特征(ROC)曲线,分析hs⁃CRP和TGF⁃β诊断儿童急性细菌性肺炎的临床价值。结果观察组血清血小板、IL⁃6、WBC水平均高于对照组(P<0.05)。治疗前急性细菌性肺炎患儿血清hs⁃CRP为(12.6±3.4)mg/L,血清TGF⁃β为(7.8±1.6)ng/L,血清TLR4为(3.8±0.2)mg/L,与对照组相比均显著上升(P<0.05)。治疗后急性细菌性肺炎患儿血清hs⁃CRP为(5.1±1.2)mg/L,血清TGF⁃β为(6.3±1.7)ng/L,血清TLR4为(2.3±0.1)mg/L,与治疗前相比均明显下降(P<0.05)。经多因素Logistic回归分析,发现血清hs⁃CRP、TGF⁃β和TLR4水平是患儿影响预后的因素。ROC曲线分析发现血清hs⁃CRP、TGF⁃β对儿童急性细菌性肺炎均有一定的的诊断价值,其中3种指标联合检测的AUC为0.832,灵敏度78.3%,特异度86.2%,联合检测效能显著高于单独指标检测(P<0.05)。结论hs⁃CRP、TGF⁃β和TLR4水平可用于评估儿童急性细菌性肺炎的病情严重程度,有利于急性细菌性肺炎患儿的临床治疗及预后评估。Objective To investigate the changes of serum hs-CRP,TGF-β and TLR4 levels in children with acute bacterial pneumonia and assess the clinical diagnostic value.Methods 113 children with acute bacterial pneumonia treated in our hospital from August 2017 to September 2018 were selected as observation group.While 100 healthy children were selected as the control group,and the basic clinical data of the two groups were recorded.Serum hs-CRP,TGF-β and TLR4 levels were detected by ELISA.Multivariate Logistic regression analysis was used to study the prognostic factors of children with acute bacterial pneumonia.The receiver operating characteristic(ROC) curve was used to analyze the clinical value of hs-CRP and TGF-(3 in the diagnosis of acute bacterial pneumonia in children.Results The levels of platelet,IL-6 and WBC in the observation group were higher than those in the control group(P<0.05).Before treatment,the serum hs-CRP,TGF-β and TLR4 levels in children with acute bacterial pneumonia were 12.6±3.4 mg/L,7.8±1.6 ng/L and 3.8±0.2 mg/L respectively,which were significantly higher than those in the control group(P<0.05).After treatment,serum hs-CRP,TGF-β and TLR4 were 5.1±1.2 mg/L,6.3±1.7 ng/L and 2.3±0.1 mg/L,which were significantly lower than those before treatment(P<0.05).Multivariate logistic regression analysis showed that serum hs-CRP,TGF-β and TLR4 levels were the prognostic factors.ROC curve analysis showed that serum hs-CRP and TGF-β had certain diagnostic value in children with acute bacterial pneumonia.The AUC,the sensitivity and the specificity of joint detection of three indicators was0.832,78.3% and 86.2%,respectively.The combined detection efficiency was significantly higher than those of single index detection(P<0.05).Conclusion The levels of hs-CRP、TGF-β and TLR4 can be used to evaluate the severity of acute bacterial pneumonia in children,which is beneficial to the clinical treatment and prognosis evaluation of children with acute bacterial pneumonia.

关 键 词：急性细菌性肺炎 超敏C⁃反应蛋白 转化生长因子⁃β Toll样受体4 

分 类 号：R725.6[医药卫生—儿科]