人中性粒细胞脂质运载蛋白对糖尿病酮症酸中毒患儿合并细菌感染的诊断价值  

Diagnostic value of human neutrophil lipid carrier protein in diabetic ketoacidosis complicated with bacterial infection

作　　者：吕洋[1] LYU Yang(Department of Pediatrics,Anshan Central Hospital of Liaoning Province,Anshan,Liaoning 114001,China)

机构地区：[1]辽宁省鞍山市中心医院儿科,辽宁鞍山114001

出　　处：《中国优生与遗传杂志》2022年第10期1780-1785,共6页Chinese Journal of Birth Health & Heredity

摘　　要：目的 探讨人中性粒细胞脂质运载蛋白(HNL)对糖尿病酮症酸中毒患儿(DKA)合并细菌感染的诊断价值,为临床诊断提供依据。方法 选取2020年7月至2021年8月收治的140例DKA患儿,根据患儿是否发生细菌感染分为感染组(70例)和无感染组(70例),收集他们的一般资料和实验室检查结果并分析DKA患儿合并细菌感染组的细菌培养结果,利用多因素Logistic回归分析DKA患儿合并细菌感染的独立危险因素,采用Pearson相关性分析HNL、CRP、白介素6、PCT与DKA患儿合并细菌感染的相关性及HNL与CRP、白介素6、PCT之间的相关性,绘制HNL、CRP、白介素6、PCT及四者联合预测DKA患儿合并细菌感染的受试者操作特征(ROC)曲线。结果 感染组的血糖、血淀粉酶、尿淀粉酶、血清淀粉样蛋白A、肝素结合蛋白、白介素6、白细胞计数、HNL、降钙素原(PCT)、C反应蛋白(CRP)高于无感染组(P<0.05),血清HCO3-低于无感染组(P<0.05),多因素分析结果显示,HNL、CRP、白介素6、PCT是DKA患儿发生细菌感染的独立危险因素(P<0.05)。HNL、CRP、白介素6、PCT与DKA患儿合并细菌感染呈正相关,且HNL与CRP、白介素6、PCT均呈正相关。ROC结果显示,HNL、CRP、白介素6、PCT四种指标联合预测及单独预测的AUC分别为0.921(95%CI:0.851~0.968)、0.902(95%CI:0.810~0.924)、0.789(95%CI:0.712~0.851)、0.875(95%CI:0.854~0.912)、0.823(95%CI:0.811~0.901)。结论 HNL、CRP、白介素6、PCT四种指标单独及联合诊断DKA患儿合并细菌感染的效果均良好,单独诊断中,HNL的诊断效果较其他三种更加准确。Objective To investigate the diagnostic value of human neutrophil lipid carrier protein in diabetic ketoacidosis with bacterial infection and to provide basis for clinical diagnosis. Methods A total of 140 children with DKA admitted to our hospital from July 2020 to August 2021 were selected, and the children were divided into infection group(70 cases)and non-infection group(70 cases) according to whether bacterial infection occurred. Their general data and laboratory examination results were collected and the bacterial culture results of DKA children with bacterial infection group were analyzed.Multivariate Logistic regression was used to analyze the independent risk factors of bacterial infection in children with DKA.Pearson correlation analysis was used to analyze the correlation between HNL, CRP, PCT, Interleukin-6, bacterial infection in children with DKA and the correlation between HNL and CRP, Interleukin-6, and PCT, Drawing ROC curves of HNL, CRP,Interleukin-6, PCT and the combination of the four factors in predicting bacterial infection in children with DKA. Results The levels of blood glucose, serum amylase, urinary amylase, serum amyloid A, heparin binding protein, interleukin 6, white blood cell count, HNL, procalcitonin and C-reactive protein in infected group were higher than those in non-infected group(P<0.05),Serum HCO3-was lower than that of non-infected group(P<0.05). Multivariate analysis showed that HNL, CRP, Interleukin-6and PCT were independent risk factors for bacterial infection in children with DKA(P<0.05). HNL, CRP, Interleukin-6, PCT were positively correlated with DKA patients complicated with bacterial infection, and HNL was positively correlated with CRP, Interleukin-6, PCT. ROC results showed that the AUC of HNL, CRP, interleukin 6 and PCT were 0.921(95%CI:0.851-0.968), 0.902(95%CI:0.810-0.924) and 0.789(95%CI:0.712-0.851), 0.875(95%CI: 0.854-0.912), 0.823(95%CI:0.811-0.901). Conclusion HNL, CRP, Interleukin-6 and PCT had good diagnostic effects on DKA patients with bacterial infect

关 键 词：糖尿病酮症酸中毒 中性粒细胞脂质运载蛋白 细菌感染 降钙素原 诊断 

分 类 号：R725.8[医药卫生—儿科]