血液学参数动态监测在小儿感染性腹泻治疗中的协同作用及预测价值  

The Synergistic Effect and Predictive Value of Dynamic Monitoring of Hematological Parameters in the Treatment of Pediatric Infectious Diarrhea

作　　者：王晗晶 王艳辉 余小红 WANG Hanjing;WANG Yanhui;YU Xiaohong(Department of Gastroenterology,Xuzhou Children's Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市儿童医院消化内科,江苏徐州221000

出　　处：《药物生物技术》2025年第1期92-96,共5页Pharmaceutical Biotechnology

摘　　要：探讨动态监测相关血液学参数在小儿感染性腹泻治疗中的协同作用及预测价值。选择2023年8月—2024年08月本院收治的183例感染性腹泻患儿为观察对象,并根据病情将患者分为轻型组、中型组和重型组。在入院当天及进行抗炎、补液和止泻等常规治疗后进行静脉采血作为样本,采用双抗体夹心酶联免疫吸附法检测样本中血清细胞因子白细胞介素(IL-6、IL-8、IL-10),降钙素原(PCT)、肝素结合蛋白(HBP)和心肌酶(CK、CK-MB)水平。比较入院时血清细胞因子3项和治疗前后CK、CK-MB、PCT和HBP水平,分析比较动态监测血清各指标水平与临床疗效的相关性。通过受试者工作特征曲线分析各指标水平检测对感染性腹泻治疗疗效的曲线下面积(AUC)、最佳诊断敏感度、特异度。感染性腹泻患者经治疗后,轻型患者全部判定为有效,而中型患者中8人、重型患者中18人病情进展继而判定为无效。有效组患者治疗前的血清细胞因子3项水平根据病情由轻到重呈现上升趋势;相较治疗前,治疗后的CK、CK-MB、PCT和HBP水平显著降低(P<0.05);中、重型患者无效组病情加重后,血清细胞因子3项、CK、CK-MB、PCT和HBP水平明显高于中、重型患者有效对照组,血清各指标均与临床治疗效果密切相关,差异有统计学意义(P<0.05)。治疗后复查血清各指标水平预测临床疗效的AUC为0.816,最佳诊断敏感度84.32%,特异度为88.67%。动态监测血清细胞因子3项、CK、CK-MB、PCT和HBP水平与感染性腹泻临床治疗疗效密切相关,对临床病情判断及用药评估有重要意义。To explore the synergistic effect and predictive value of dynamically monitoring relevant hematological parameters in the treatment of pediatric infectious diarrhea,a total of 183 children with infectious diarrhea admitted to Xuzhou Children's Hospital from August 2023 to August 2024 were selected as study subjects.Patients were divided into mild,moderate,and severe groups based on disease severity.Venous blood samples were collected on the day of admission and after conventional treatments such as anti-inflammatory therapy,fluid replacement,and anti-diarrheal treatment.Serum cytokine levels(IL-6,IL-8,IL-10),procalcitonin(PCT),heparin-binding protein(HBP),and myocardial enzymes(CK,CK-MB)were detected using a double-antibody sandwich enzyme-linked immunosorbent assay(ELISA).The serum cytokine levels at admission and pre-and post-treatment levels of CK,CK-MB,PCT,and HBP were compared,and the correlation between dynamic monitoring of these indicators and clinical efficacy was analyzed.The area under the curve(AUC),optimal diagnostic sensitivity,and specificity of these indicators in predicting treatment outcomes for infectious diarrhea were assessed using receiver operating characteristic(ROC)curve analysis.After treatment,all mild cases were deemed effective,while 8 moderate and 18 severe cases showed disease progression and were deemed ineffective.The pre-treatment serum cytokine levels of the three markers showed an upward trend with increasing disease severity.Compared to pre-treatment levels,post-treatment CK,CK-MB,PCT,and HBP levels significantly decreased(P<0.05).In moderate and severe cases deemed ineffective,serum cytokine levels,CK,CK-MB,PCT,and HBP levels were significantly higher compared to those in the effective group,indicating a significant correlation between these serum indicators and clinical efficacy(P<0.05).The AUC for predicting clinical efficacy using post-treatment serum levels was 0.816,with an optimal diagnostic sensitivity of 84.32%and specificity of 88.67%.Dynamic monitoring of serum cyto

关 键 词：感染性腹泻 细胞因子 肌酸激酶 肌酸激酶同工酶 降钙素原 肝素结合蛋白 受试者工作特征曲线 

分 类 号：R574[医药卫生—消化系统] R392[医药卫生—内科学]