血清hs-CRP、PCT、sB7-H3及LTB4联合检测在儿童肺炎中的早期诊断价值分析  

Value of the combined detection with serum hs-CRP,PCT,sB7-H3 and LTB4 in the early diagnosis of children pneumonia

作　　者：马兵兵 管华 王花珍 MA Bing-bing;GUAN Hua;WANG Hua-zhen(Department of Laboratory Medicine,Zhangjiakou Maternal and Child Health Hospital,Zhangjiakou Hebei 075000,China)

机构地区：[1]张家口市妇幼保健院检验科,河北张家口075000

出　　处：《临床和实验医学杂志》2021年第22期2435-2439,共5页Journal of Clinical and Experimental Medicine

基　　金：张家口市重点研发计划项目(编号:1921100D)。

摘　　要：目的研究血清超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、可溶性B7-H3(sB7-H3)及白三烯B4(LTB4)联合检测在儿童肺炎中的早期诊断价值。方法回顾性分析2019年9月至2020年10月张家口市妇幼保健院收治的120例肺炎患儿的病例资料,作为肺炎组,另外选取30例正常健康儿童作为正常组,比较各组的血清hs-CRP、PCT、sB7-H3及LTB4水平,利用受试者工作特征(ROC)曲线分析血清hs-CRP、PCT、sB7-H3、LTB4水平对儿童肺炎以及不同程度细菌性肺炎的诊断效能。结果肺炎组的hs-CRP、PCT、sB7-H3及LTB4水平均显著高于正常组,差异均有统计学意义(P<0.05)。细菌性肺炎组的hs-CRP、PCT、sB7-H3水平均显著高于病毒性肺炎组,差异均有统计学意义(P<0.05)。细菌性肺炎重度组的hs-CRP、PCT、sB7-H3水平均显著高于轻度组,差异均有统计学意义(P<0.05)。血清hs-CRP、PCT、sB7-H3、LTB4联合检测诊断儿童肺炎的曲线下面积(AUC)为0.961(95%CI:0.897~0.990),且联合诊断的AUC高于单一诊断(P<0.05);血清hs-CRP、PCT、sB7-H3联合检测鉴别病毒性、细菌性肺炎的AUC为0.946(95%CI:0.889~0.979),且联合鉴别的AUC高于单一鉴别(P<0.05);血清hs-CRP、PCT、sB7-H3联合鉴别轻、重度细菌性肺炎的AUC为0.926(95%CI:0.769~0.989),且联合鉴别的AUC高于单一鉴别(P<0.05)。结论血清hs-CRP、PCT、sB7-H3检测有助于小儿细菌性肺炎的早期诊断以及病情严重程度的评估,且联合检测评估价值更高。Objective To study the value of combined detection with serum high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),soluble B7-H3(sB7-H3)and leukotriene B4(LTB4)in the early diagnosis of children pneumonia.Methods The pathological data of 120 pneumonia children(pneumonia group)admitted to Zhangjiakou Maternal and Child Health Hospital from September 2019 to October 2020 were retrospectively analyzed.Another 30 normal and healthy children were enrolled as normal group.The levels of serum hs-CRP,PCT,sB7-H3 and LTB4 were compared between the two groups.And their diagnostic efficiency for children pneumonia and different degree of bacterial pneumonia was analyzed by receiver operating characteristic(ROC)curves.Results The levels of hs-CRP,PCT,sB7-H3 and LTB4 in pneumonia group were significantly higher than those in normal group,the differences were statistically significant(P<0.05).The levels of hs-CRP,PCT and sB7-H3 in bacterial pneumonia group were significantly higher than those in viral pneumonia group,the differences were statistically significant(P<0.05).The levels of hs-CRP,PCT and sB7-H3 in the severe bacterial pneumonia group were significantly higher than those in the mild group,and the differences were statistically significant(P<0.05).Area under the curve(AUC)of serum hs-CRP combined with PCT,sB7-H3 and LTB4 for diagnosis of children pneumonia was 0.961(95%CI:0.897-0.990),which was higher than that of single index(P<0.05).AUC of serum hs-CRP combined with PCT and sB7-H3 for distinguishing viral and bacterial pneumonia was 0.946(95%CI:0.889-0.979),which was higher than that of single index(P<0.05).AUC of serum hs-CRP combined with PCT and sB7-H3 for distinguishing mild and severe bacterial pneumonia was 0.926(95%CI:0.769-0.989),which was higher than that of single index(P<0.05).Conclusion The detection of serum hs-CRP,PCT and sB7-H3 is conductive to the early diagnosis of bacterial pneumonia and the evaluation of disease severity in children.And evaluation value of combined detection is higher.

关 键 词：儿童肺炎 C反应蛋白 降钙素原 可溶性B7-H3 白三烯B4 

分 类 号：R725.6[医药卫生—儿科]