外周血炎症指标联合检测在儿童下呼吸道早期感染中的诊断价值  

Diagnostic Value of Combined Detection of Peripheral Blood Inflammatory Markers for Early Lower Respiratory Tract Infection in Children

作　　者：隆霞 毛小倩 刘伟平[1] Long Xia;Mao Xiaoqian;Liu Weiping(Department of Clinical Laboratory,Zigong First People's Hospital,Zigong 643000,China)

机构地区：[1]自贡市第一人民医院检验科,自贡643000

出　　处：《成都医学院学报》2024年第1期24-27,33,共5页Journal of Chengdu Medical College

基　　金：国家重点研发计划重点专项子课题(No:2019YFF0216501-Z51)。

摘　　要：目的探讨血清白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、全血中性粒细胞与淋巴细胞比值(NLR)联合检测在儿童下呼吸道细菌和病毒早期感染中的鉴别诊断价值。方法收集自贡市第一人民医院2023年1—10月初诊入院的急性下呼吸道感染儿童215例为研究对象,根据感染病原体的类型将其分为细菌感染组(117例)和病毒感染组(98例)。对两组患儿血清IL-6、hs-CRP和全血NLR检测结果进行回顾性分析。采用受试者工作特征曲线(ROC)评估血清IL-6、hs-CRP和NLR及三者联合检测的诊断价值。结果细菌感染组IL-6、hs-CRP和NLR指标均高于病毒感染组,差异有统计学意义(P<0.05);IL-6、hs-CRP和NLR的ROC曲线下面积(AUC)分别为0.839(95%CI:0.765~0.913)、0.783(95%CI:0.693~0.873)和0.840(95%CI:0.769~0.912)。IL-6、hs-CRP和NLR联合检测的AUC为0.875(95%CI:0.810~0.940)。IL-6、hs-CRP和NLR的最佳截断值分别为33.54 ng/L、32.15mg/L、9.62;IL-6单独诊断的灵敏度为67.1%、特异度为91.6%、约登指数为0.587;hs-CRP单独诊断的灵敏度为80.6%、特异度为72.9%、约登指数为0.600;NLR单独诊断的灵敏度为67.2%、特异度为91.7%、约登指数为0.589。三者联合诊断的灵敏度为79.2%、特异度为82.1%、约登指数为0.613。结论血清IL-6、hs-CRP和全血NLR测定均可用于儿童急性下呼吸道细菌感染和病毒感染的早期鉴别诊断,但三者联合检测诊断效能更高。Objective To evaluate the differential diagnostic value of the combined detection of serum interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and whole blood neutrophil to lymphocyte ratio(NLR)for early acute lower respiratory tract infection(ALRTI)of bacterial or virus in children.Methods A total of 215 children with ALRTI admitted to Zigong First People's Hospital from January to October 2023 were selected as the research objects.They were divided into either a bacterial infection group(n=117)or a virus infection group(n=98)according to the types of pathogens.The results of serum IL-6,hs-CRP and whole blood NLR were analyzed retrospectively.The differential diagnostic value of the three test indexes as well as their combined detection for bacterial infection and virus infection were compared using receiver operating characteristic(ROC)curve.Results The levels of IL-6,hs-CRP and NLR in bacterial infection group were higher than those in virus infection group,and the differences were statistically significant(P<0.05).The area under the curve(AUC)of ROC of IL-6,hs-CRP and NLR was 0.839(95%CI:0.765-0.913),0.783(95%CI:0.693-0.873)and 0.840(95%CI:0.769-0.912),respectively.The AUC of the combined detection of IL-6,hs-CRP and NLR was 0.875(95%CI:0.810-0.940).The diagnostic cut-off values of IL-6,hs-CRP and NLR were 33.54 ng/L,32.15 mg/L and 9.62,respectively.The diagnostic sensitivity,specificity and Youden index of IL-6 were 67.1%,91.6%%and 0.587,respectively.The diagnostic sensitivity,specificity and Youden index of hs-CRP were 80.6%,72.9%and 0.600,respectively.The diagnostic sensitivity,specificity and Youden index of NLR were 67.2%,91.7%and 0.589,respectively.The diagnostic sensitivity,specificity and Youden index of their combined detection were 79.2%,82.1%and 0.613,respectively.Conclusion The detection of serum IL-6,hs-CRP and whole blood NLR has certain clinical value for the differential diagnosis of early ALRTI of bacterial or virus infection in children,but the combined detection of the three has

关 键 词：急性下呼吸道感染 白细胞介素-6 中性粒细胞与淋巴细胞比值 超敏C反应蛋白 

分 类 号：R446.6[医药卫生—诊断学]