白介素-6、降钙素原和超敏C反应蛋白在新生儿细菌感染性肺炎患儿血清中的水平变化及诊断效能分析  

Changes of serum levels of interleukin-6, procalcitonin and hypersensitive C-reactive protein in neonates with bacterial pneumonia and analysis of diagnostic efficacy

作　　者：郭宗荣 汤翰 GUO Zongrong;TANG Han(Department of Neonatology,Yichun Maternal and Child Health Hospital,Jiangxi Province,Yichun336000,China)

机构地区：[1]江西省宜春市妇幼保健院新生儿科,江西宜春336000

出　　处：《中国当代医药》2022年第36期103-106,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP_220210274)。

摘　　要：目的 探究白介素-6(IL-6)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)在新生儿细菌感染性肺炎患儿血清中的水平变化及诊断效能。方法 回顾性分析2019年3月至2021年6月宜春市妇幼保健院新生儿科收治的76例肺炎患儿的临床资料,根据痰液标本培养结果明确细菌感染性肺炎患儿42例入选细菌感染组,另34例患儿为非细菌感染纳入非细菌感染组。比较两组的血清PCT、hs-CRP、IL-6水平;以痰液标本培养结果为“金标准”,分析PCT、hs-CRP、IL-6检测在细菌感染性肺炎患儿中的诊断价值。结果 细菌感染组血清PCT、hs-CRP、IL-6水平均高于非细菌感染组,差异有统计学意义(P<0.05)。ROC曲线显示,PCT在细菌感染性肺炎诊断中AUC为0.811,敏感度为97.6%,特异度为64.7%;hs-CRP在细菌感染性肺炎诊断中AUC为0.759,敏感度为88.1%,特异度为50.0%;IL-6在细菌感染性肺炎诊断中AUC为0.777,敏感度为92.9%,特异度为73.5%;联合检测在细菌感染性肺炎诊断中AUC为0.924,敏感度为100.0%,特异度为94.1%。联合检测在细菌感染性肺炎诊断中AUC值最大,且敏感度及特异度最高。结论 应用血清PCT、hs-CRP、IL-6联合检测的方式鉴别诊断新生儿细菌感染性肺炎中诊断效能较高,可依据各指标水平变化判断患儿病情严重程度,为临床诊疗提供可靠参考依据,值得推广应用。Objective To investigate the changes of serum levels of interleukin-6(IL-6), procalcitonin(PCT) and hypersensitive C-reactive protein(hs-CRP) in neonates with bacterial pneumonia and their diagnostic efficacy. Methods The clinical data of 76 children with pneumonia admitted to the Department of Neonatology, Yichun Maternal and Child Health Hospital from March 2019 to June 2021 were retrospectively analyzed. According to the sputum specimen culture results, 42 children with bacterial pneumonia were included in the bacterial infection group, and 34 children with non bacterial infection were included in the non bacterial infection group. The levels of serum PCT, hs-CRP and IL-6 were compared between the two groups. Using sputum culture results as the "gold standard", the diagnostic value of PCT, hs-CRP and IL-6 in children with bacterial pneumonia was analyzed. Results The levels of serum PCT, hs-CRP and IL-6 in bacterial infection group were significantly higher than those in non bacterial infection group, with statistically significant differences(P<0.05). ROC curve showed that the AUC of PCT in the diagnosis of bacterial infectious pneumonia was 0.811,the sensitivity was 97.6%, and the specificity was 64.7%. The AUC, sensitivity and specificity of hs-CRP in the diagnosis of bacterial infectious pneumonia were 0.759, 88.1% and 50.0%. The AUC of IL-6 in the diagnosis of bacterial pneumonia was0.777, the sensitivity was 92.9%, and the specificity was 73.5%. The AUC, sensitivity and specificity of combined test in the diagnosis of bacterial infection pneumonia were 0.924, 100.0% and 94.1%. Combined test had the highest AUC value and the highest sensitivity and specificity in the diagnosis of bacterial infection pneumonia. Conclusion The combined detection of serum PCT, hs-CRP and IL-6 has a high diagnostic efficiency in the differential diagnosis of neonatal bacterial pneumonia. It can judge the severity of children’s disease according to the changes of each index level, and provide a reliable reference for clinica

关 键 词：细菌感染性肺炎 新生儿 白介素-6 降钙素原 超敏C反应蛋白 一致性 

分 类 号：R563.1[医药卫生—呼吸系统]