血清降钙素原、C反应蛋白、D二聚体及IL-6检测在重症肺炎患儿中的应用研究  

Study on application of combined detection of serum procalcitonin,C-reactive protein,D-dimer and IL-6 in the diagnosis of severe pneumonia in children

作　　者：曾晓兵 张筱婷 ZENG Xiao-bing;ZHANG Xiao-ting(Department of Pediatrics,Zhangye Second People's Hospital,Zhangye 734000,China)

机构地区：[1]张掖市第二人民医院儿科,734000 [2]张掖市甘州区人民医院妇产科,734000

出　　处：《中国现代药物应用》2022年第24期17-21,共5页Chinese Journal of Modern Drug Application

基　　金：甘肃省自然科学基金(项目编号:21JR1RG311)。

摘　　要：目的分析在儿童重症肺炎诊断中进行血清降钙素原、C反应蛋白、D二聚体及白细胞介素-6(IL-6)联合检测的意义。方法回顾性选取200例儿童重症肺炎患儿进行研究,其中5例死亡患儿作为死亡组,195例好转患儿作为好转组。两组患儿均接受血清降钙素原、C反应蛋白、D二聚体、IL-6检测及痰培养、胸水检测。分析两组病原菌分布情况,比较两组不同时间点(治疗第1、3、7天及转出/死亡当天)C反应蛋白、D二聚体、血清降钙素原、IL-6水平。结果好转组患儿革兰阳性菌占比低于革兰阴性菌,主要致病菌为溶血性葡萄球菌、肺炎克雷伯菌;死亡组患儿革兰阳性菌占比低于革兰阴性菌,主要致病菌为铜绿假单胞菌,真菌较为少见。好转组患儿治疗第1、3、7天及转出当天的C反应蛋白水平分别为(73.15±2.16)、(60.75±0.94)、(43.19±1.06)、(31.02±0.41)mg/L,呈下降趋势,比较差异具有统计学意义(P<0.05);死亡组患儿治疗第1、3、7天及死亡当天的C反应蛋白水平分别为(73.14±2.17)、(90.15±0.16)、(105.13±1.03)、(117.16±0.29)mg/L,呈上升趋势,比较差异具有统计学意义(P<0.05);两组患儿治疗第1天C反应蛋白水平比较差异无统计学意义(P>0.05);好转组患儿治疗第3、7天及转出当天的C反应蛋白水平均低于死亡组,差异具有统计学意义(P<0.05)。好转组患儿治疗第1、3、7天及转出当天的血清降钙素原水平分别为(11.36±0.67)、(7.71±0.42)、(5.64±0.21)、(4.42±0.12)μg/L,呈下降趋势,比较差异具有统计学意义(P<0.05);死亡组患儿治疗第1、3、7天及死亡当天的血清降钙素原水平分别为(11.37±0.66)、(15.74±0.16)、(17.79±0.42)、(19.57±0.15)μg/L,呈上升趋势,比较差异具有统计学意义(P<0.05);两组患儿治疗第1天血清降钙素原水平比较差异无统计学意义(P>0.05);好转组患儿治疗第3、7天及转出当天的血清降钙素原水平均低于死亡组,差异具有统计�Objective To analyze the significance of combined detection of serum procalcitonin,C-reactive protein,D-dimer and interleukin-6(IL-6)in the diagnosis of severe pneumonia in children.Methods A retrospective study was conducted on 200 children with severe pneumonia,including 5 dead children as the death group and 195 improved children as the improvement group.Children in both groups received serum procalcitonin,C-reactive protein,D-dimer,IL-6 tests and sputum culture and pleural fluid tests.The distribution of pathogens in the two groups was analyzed,and the levels of C-reactive protein,D-dimer,serum procalcitonin and IL-6 at different time points(day 1,3 and 7 of treatment and the day of transfer out/death)in the two groups were compared.Results The proportion of gram-positive bacteria in the improved group was lower than that of Gram-negative bacteria,and the main pathogens were hemolytic staphylococcus and Klebsiella pneumoniae;the proportion of Gram-positive bacteria in the death group was lower than that of Gram-negative bacteria,and the main pathogens were Pseudomonas aeruginosa,and fungi were rare.The C-reactive protein levels of children in the improved group were(73.15±2.16),(60.75±0.94),(43.19±1.06),and(31.02±0.41)mg/L on day 1,3,and 7 of treatment and on the day of transfer out,showing a decreasing trend,and the differences were statistically significant(P<0.05).The C-reactive protein levels of children in the death group were(73.14±2.17),(90.15±0.16),(105.13±1.03),and(117.16±0.29)mg/L on day 1,3,and 7 of treatment and on the day of transfer out,showing an upward trend,and the differences were statistically significant(P<0.05).On day 1 of treatment,there was no statistically significant difference in C-reactive protein between the two groups(P>0.05).The C-reactive protein levels of children in the improved group were lower than those in the death group on day 3 and 7 of treatment and on the day of transfer out,and the difference was statistically significant(P<0.05).The serum procalcitonin levels

关 键 词：血清降钙素原 儿童重症肺炎 C反应蛋白 D二聚体 病原菌 白细胞介素-6 

分 类 号：R725.6[医药卫生—儿科]