儿童急性下呼吸道感染病原菌分布情况及血清LDH/ALB,PD-L1的检测分析  

Distribution of pathogenic bacteria in acute lower respiratory tract infections in children and detection and analysis of serum LDH/ALB and PD-L1

作　　者：杜维新 吕建华[2] 刘湛[3] 张俊霞[4] 吉自敏[2] DU Weixin;LV Jianhua;LIU Zhan;ZHANG Junxia;JI Zimin(Basic MedicalTeaching Department,Puyang Medical College,Puyang,Henan 457000,China;Pharmacy Department,Puyang People's Hospital;Department of Laboratory Medicine,Puyang People's Hospital;Department of Pediatric Internal Medicine,Puyang People'sHospital)

机构地区：[1]濮阳医学高等专科学校基础医学教学部,河南濮阳457000 [2]濮阳市人民医院药学部 [3]濮阳市人民医院检验科 [4]濮阳市人民医院儿童内科学

出　　处：《中国病原生物学杂志》2025年第3期311-315,共5页Journal of Pathogen Biology

摘　　要：目的探究儿童急性下呼吸道感染(ALRTI)病原菌分布情况及血清乳酸脱氢酶(LDH)/白蛋白(ALB),程序性死亡配体-1(PD-L1)的检测分析。方法本研究选择2021年6-2023年6在濮阳市人民医院就诊的92例ALRTI患儿记为ALRTI组,另选85例在本院体检的儿童为对照组,全自动细菌鉴定仪鉴定痰样本中病原菌分布。ELISA检测PD-L1、白细胞介素-6(IL-6)、降钙素原(PCT)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平;全自动血液细胞分析仪检测血红蛋白(Hb)、红细胞(RBC)、血小板(PLT)、淋巴细胞(LYM)、单核细胞(MON)、白细胞(WBC)、中性粒细胞(NEU)等血常规指标;全自动生化分析仪检测ALB、肌酐(Cre)、LDH、腺苷脱氨酶(ADA)、癌胚抗原(CEA)水平,并计算LDH/ALB比值。多因素Logistic回归分析ALRTI发生的影响因素;Pearson分析LDH/ALB、PD-L1水平与各影响因子的相关性;ROC曲线分析LDH/ALB、PD-L1水平对ALRTI发生的诊断价值,Z检验比较AUC的差异。结果ALRTI患儿痰液革兰阴性杆菌占比最高;ALRTI组咳嗽例数、生化指标(LDH、ADA、CEA)、血常规指标(Hb、MON、WBC、NEU)、炎症因子(IL-6、CRP、TNF-α、PCT)水平以及LDH/ALB、PD-L1水平升高,但LYM、ALB、Cre水平下降(P<0.05);CEA、Cre、IL-6、CRP、LDH/ALB、PD-L1为儿童发生ALRTI的影响因素(P<0.05)LDH/ALB、PD-L1与CEA、IL-6、CRP水平相关,与Cre水平呈负相关(P<0.05);LDH/ALB、PD-L1联合诊断的AUC为0.915,优于各自单独诊断(均P<0.05)。结论ALRTI患儿痰液中占比最高的是革兰阴性杆菌,血清LDH/ALB、PD-L1水平升高,并与生化指标和炎症因子水平相关,两者联合诊断儿童发生ALRTI具有一定的价值。Objective To investigate the distribution of pathogenic bacteria in acute lower respiratory tract infection(ALRTI)in children and to detect serum lactate dehydrogenase(LDH)/albumin(ALB)and programmed death ligand 1(PD-L1).Methods This study selected 92 children with ALRTI who received medical treatment at Puyang People's Hospital from June 2021 to June 2023 as the ALRTI group,and another 85 children who underwent physical check ups as control group.The distribution of pathogenic bacteria in sputum samples was identified using a fully automated bacterial identification device.ELISA was applied to detect PD-L1,interleukin-6(IL-6),procalcitonin(PCT),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α).Fully automated blood cell analyzer was applied to detect blood routine indicators such as hemoglobin(Hb),red blood cells(RBC),platelet(PLT),lymphocyte(LYM),monocytes(MON),white blood cells(WBC),and neutrophil(NEU).Fully automated biochemical analyzer was applied to measure ALB,creatinine(Cre),LDH,adenosine deaminase(ADA),and carcinoembryonic antigen(CEA),and the LDH/ALB ratio was calculated.Multivariate logistic regression was applied to analyze the influencing factors of occurrence of ALRTI.Pearson was applied to analyze the correlation between LDH/ALB,PD-L1 and various influencing factors.ROC curve was applied to analyze the diagnostic value of LDH/ALB and PD-L1 for the occurrence of ALRTI,and Z-test was used to compare the differences in AUC.Results Children with ALRTI had the highest proportion of Gram negative bacteria in sputum.The number of cough cases,levels of biochemical indicators(LDH,ADA,CEA),blood routine indicators(Hb,MON,WBC,NEU),inflammatory factors(IL-6,CRP,TNF-α,PCT),LDH/ALB,and PD-L1 increased in the ALRTI group,but the LYM,ALB,and Cre decreased(P<0.05).CEA,Cre,IL-6,CRP,LDH/ALB,and PD-L1 were the influencing factors for the occurrence of ALRTI in children(P<0.05).LDH/ALB and PD-L1 were correlated with CEA,IL-6,CRP,and negatively correlated with Cre(P<0.05).The AUC of combined diagnosis of L

关 键 词：儿童急性下呼吸道感染 病原菌分布 乳酸脱氢酶/白蛋白 程序性死亡配体-1 诊断价值 

分 类 号：R73[医药卫生—肿瘤]