入院早期感染标志物及淋巴细胞亚群对儿童细菌性肺炎的预测价值  

Values of infection markers and lymphocyte subsets at early stage of admission in prediction of bacterial pneumonia in children

作　　者：林夏云 罗亚凤 王文[1] 张新卉 童叶英 王丹[1] LIN Xia-yun;LUO Ya-feng;WANG Wen;ZHANG Xin-hui;TONG Ye-ying;WANG Dan(The First Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570lo2,China)

机构地区：[1]海南医学院第一附属医院儿科,海南海口570102

出　　处：《中华医院感染学杂志》2024年第3期416-420,共5页Chinese Journal of Nosocomiology

基　　金：海南省医药卫生科研基金资助项目(21A200346)。

摘　　要：目的对比分析入院早期感染标志物及淋巴细胞亚群对儿童细菌性肺炎的预测价值.方法选取2021年3月-2023年3月由海南医学院第一附属医院收治的104例细菌性社区获得性肺炎(CAP)患儿作为研究组,根据其后续住院治疗期间病情转归分为重症组(48例)和普通组(56例),选取同期110名接受健康体检儿童作为对照组;检测各组儿童外周血白细胞计数(WBC)、中性粒细胞计数(NEU)、红细胞沉降率(ESR)、CD^(+)_(4)T淋巴细胞比例、CD^(+)_(8)T淋巴细胞比例、CD^(+)_(4)/CD^(+)_(8)T淋巴细胞比值及血清降钙素原(PCT)、C-反应蛋白(CRP)水平.结果重症组和普通组患儿的感染标志物水平均高于对照组,CD^(+)_(4)、CD^(+)_(8)、CD^(+)_(4)/CD^(+)_(8)均低于对照组,重症组患儿的PCT、CRP高于普通组,CD^(+)_(4)、CD^(+)_(4)/CD^(+)_(8)均低于普通组(P<0.05);PCT、CRP、CD^(+)_(4)、CD^(+)_(4)/CD^(+)_(8)预测儿童细菌性肺炎病情的受试者工作特征(ROC)曲线下面积(AUC)均有统计学意义(P<0.05),其中,CD^(+)_(4)/CD^(+)_(8)AUC最高,其次为PCT,CD^(+)_(4)/CD^(+)_(8)的灵敏度最高,CRP的特异度最高.结论与普通细菌性CAP患儿比较,重症CAP患儿在入院早期即可表现为PCT、CRP等感染标志物及T淋巴细胞亚群的异常,检测上述指标可作为预测患儿病情的参考依据.OBJECTIVE To compare and analyze the predictive value of early infection markers and lymphocyte sub-sets on admission in children with bacterial pneumonia.METHODS Totally 104 children with bacterial community-acquired pneumonia(CAP)admitted to the pediatric department of the First Affiliated Hospital of Hainan Medical College from Mar.2021 to Mar.2023 were selected as the study group,and were divided into a severe group(48 cases)and a general group(56 cases)according to regression of their conditions during the subsequent hospitaliza-tion,and 110 children who underwent health examinations during the same period were selected as the control group.The white blood cell count(WBC),neutrophil count(NEU),erythrocyte sedimentation rate(ESR),CD^(+)_(4)T lymphocyte percentage,CD^(+)_(8)T lymphocyte percentage,CD^(+)_(4)/CD^(+)_(8)T lymphocyte ratio in peripheral blood,and the serum levels of procalcitonin(PCT)and C-reactive protein(CRP)of children in each group were detected.RESULTS The infection markers in the severe group and the general group were all higher than those in the control group,while CD^(+)_(4)T lymphocyte percentage,CD^(+)_(8)T lymphocyte percentage,CD^(+)_(4)/CD^(+)_(8)T lympho-cyte ratio were all lower than those in the control group.The PCT and CRP levels in the severe group were higher than those in the general group,while CD^(+)_(4)T lymphocyte percentage and CD^(+)_(4)/CD^(+)_(8)T lymphocyte ratio were all lower than those in the general group(P<0.05).The areas under the receiver operating characteristic curve(AUC)for PCT,CRP,CD^(+)_(4)T lymphocyte percentage and CD^(+)_(4)/CD^(+)_(8)T lymphocyte ratio to predict the severi-ty of bacterial pneumonia in children was statistically significant(P<0.05),of which the AUC of CD^(+)_(4)/CD^(+)_(8)T lymphocyte ratio was the highest,followed by PCT,with CD^(+)_(4)/CD^(+)_(8)T lymphocyte ratio having the highest sen-sitivity and CRP having the highest specificity.CONCLUSION Compared with children with common bacterial CAP,children with severe CAP exhibited abno

关 键 词：感染标志物 T淋巴细胞亚群 儿童细菌性肺炎 病情预测 降钙素原 C-反应蛋白 白细胞计数 中性粒细胞计数 红细胞沉降率 儿童社区获得性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]