外周血炎症因子联合检测在儿童社区获得性肺炎诊断中的临床应用  

Clinical application of combined detection of peripheral blood inflammatory factors in the diagnosis of community-acquired pneumonia in children

作　　者：吴西彩[1] 王家安[1] 夏向峰 WU Xi-cai;WANG JIa-an;XIA Xiang-feng(Shandong Province Rizhao City People's Hospital,Shandong Rizhao 276826)

机构地区：[1]山东省日照市人民医院,山东日照276826 [2]山东省日照市精神卫生中心,山东日照276800

出　　处：《医学检验与临床》2021年第3期10-14,共5页Medical Laboratory Science and Clinics

摘　　要：目的:探讨外周血炎性因子降钙素原(PCT)、C-反应蛋白(CRP)、白介素-6(IL-6)、白细胞(WBC)联合检测在儿童社区获得性肺炎(CAP)诊断中的临床应用价值。方法:选取我院儿科病房收治的103例儿童CAP(病例组)及同期健康体检儿童50例(对照组)为研究对象,电化学发光法检测血清PCT、IL-6、CRP,全自动血液分析仪检测WBC的水平,Pearson相关分析PCT和IL-6与传统炎症指标CRP和WBC的相关性,绘制PCT、IL-6、CRP、WBC“受试者工作特征”(Receiver OperatingCharacteristic)曲线,回顾性统计分析各炎症指标联合检测对儿童CAP的诊断价值。结果:儿童CAP组PCT、CRP、IL-6、WBC水平分别为[(1.371.24)ng/ml、(43.81±15.31)mg/L、(67.87±22.41)pg/ml、(11.253.33)10^(9)/L]明显高于健康对照组[(0.33±0.18)ng/ml、(12.06±3.46)mg/L、(8.59±2.89)pg/ml、(7.85±2.99)10^(9)/L],均P<0.01;Pearson相关分析PCT、IL-6与CRP和WBC呈明显正相关(r=0.836、0.689、0.686、0.539),均P<0.01;ROC曲线求取PCT、CRP、IL-6和WBC诊断儿童CAP最佳截断值分别为0.50 ng/ml、8.56 mg/L、8.70pg/ml、和8.60×10^(9)/L,PCT、CRP、IL-6和WBC诊断儿童CAP敏感性分别为73.79%、98.60%、89.32%和82.52%,特异性86.00%、44.00%、62.00%和60.60%,四项指标联合检测诊断儿童CAP的ROC曲线面积最大(0.917),敏感性、特异性分别为82.52%、84.00%。结论:PCT和IL-6诊断儿童CAP价值优于CRP和WBC,但多指标联合检测可以做到相互补充、相互印证,提高诊断儿童CAP准确度。Objective:To explore the clinical value of combined detection of peripheral blood inflammatory factor procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6)and white blood cells(WBC)in the diagnosis of community-acquired pneumonia(CAP)in children.Methods:Selection of 103 cases admitted in our hospital pediatric ward children CAP the same period(case group)and 50 healthy check-up children cases(control group)as the research object,and the electrochemical luminescence method to detect the serum PCT,IL-6,CRP,fully automatic blood analyzer test the level of WBC,Pearson correlation analysis of PCT and IL-6 and traditional inflammation index the correlation of CRP and WBC,draw the PCT,IL-6,CRP,WBC"the receiver-operating characteristics"(Receiver Operating Characteristic)curve,Retrospective statistical analysis was conducted to evaluate the diagnostic value of the combined detection of various inflammatory markers in children with CAP.Results:The levels of PCT,CRP,IL-6 and WBC in children with CAP were significantly higher than those in healthy control group[(1.37±1.24)ng/ml,(43.81±15.31)mg/L,(67.87±22.41)pg/ml,(11.25±3.33)10^(9)/L],respectively,all P<0.01.PCT and IL-6 were positively correlated with CRP and WBC by Pearson correlation analysis(r=0.836,0.689,0.686,0.539),all P<0.01.The optimal cutoff values of PCT,CRP,IL-6 and WBC for the diagnosis of CAP in children were 0.50 ng/ml,8.56 mg/L,8.70pg/ml,and 8.60×10^(9)/L,respectively.The sensitivity of PCT,CRP,IL-6 and WBC for the diagnosis of CAP in children was 73.79%,98.60%,89.32%and 82.52%,and the specificity was 86.00%,44.00%,62.00%and 60.60%,respectively.The ROC curve area of CAP was the largest(0.917),and the sensitivity and specificity were 82.52%and 84.00%,respectively.Conclusion:The value of PCT and IL-6 in the diagnosis of CAP in children is better than that of CRP and WBC,but the combined detection of multiple indicators can complement and verify each other,and improve the accuracy of CAP diagnosis in children.

关 键 词：CAP 儿童 PCT、CRP、IL-6、WBC 联合检测 

分 类 号：R72[医药卫生—儿科]