CRP/PA、PCT/ALB、MCP-1、sICAM-1评估新生儿感染性肺炎病情程度及预后的价值  

The value of CRP/PA,PCT/ALB,MCP-1,and sICAM-1 in assessing the severity and prognosis of infectious pneumonia of the newborn

作　　者：孙欣 翟盟 周雯 SUN Xin;ZHAI Meng;ZHOU Wen(Department of Neonatology,Xianyang Hospital of Yan′an University,Shaanxi Province,Xianyang 712000,China;Department of Respiratory Medicine,Xi′an Qidi Children′s Hospital,Shaanxi Province,Xi′an 710000,China)

机构地区：[1]延安大学咸阳医院新生儿科,陕西咸阳712000 [2]西安启迪儿童医院呼吸科,陕西西安710000

出　　处：《河北医科大学学报》2025年第4期412-417,共6页Journal of Hebei Medical University

基　　金：陕西省重点研发计划项目(2021SF-036)。

摘　　要：目的探究血清C反应蛋白(C-reactive protein,CRP)/前白蛋白(prealbumin,PA)比值、降钙素原(procalcitonin,PCT)/白蛋白(albumin,ALB)比值、单核细胞趋化蛋白1(monocyte chemotactic protein-1,MCP-1)、可溶性细胞间黏附分子1(soluble intercellular adhesion molecules-1,sICAM-1)对新生儿感染性肺炎(infectious pneumonia,IPN)病情程度及预后的诊断价值。方法选取2020年1月—2023年1月延安大学咸阳医院新生儿科收治的IPN患儿146例的临床资料进行回顾性研究,根据病情严重程度将IPN患儿分为重症组(n=84例)和非重症组(n=62例),根据预后将新生儿分为预后不良组(n=44例)和预后良好组(n=40)。比较各组患儿血清CRP及PA水平、CRP/PA比值、血清PCT及ALB水平、PCT/ALB比值、MCP-1及sICAM-1水平;采用Pearson相关分析CRP/PA比值、PCT/ALB比值、MCP-1及sICAM-1水平与IPN病情严重程度的相关性;采用受试者工作特征(receiver operating characteristic,ROC)曲线判断血清CRP及PA水平、CRP/PA比值、血清PCT及ALB水平、PCT/ALB比值、MCP-1及sICAM-1水平对IPN严重程度的诊断效能及预后的预测价值。结果重症组CRP和PCT水平、CRP/PA比值、PCT/ALB比值、MCP-1及sICAM-1水平高于非重症组,PA和ALB水平低于非重症组(P<0.05);预后不良组CRP和PCT水平、CRP/PA比值、PCT/ALB比值、MCP-1及sICAM-1水平高于预后良好组患儿,PA和ALB水平低于预后良好组(P<0.05);Pearson分析结果显示,CRP/PA比值、PCT/ALB比值、MCP-1及sICAM-1水平与IPN患儿病情严重程度呈正相关(P<0.05);ROC曲线分析结果显示,血清sICAM-1水平比值诊断IPN病情严重程度的诊断价值最高,AUC值为0.978,95%CI:0.956~1.000。血清sICAM-1水平对IPN预后的诊断价值最高,AUC值为0.981,95%CI:0.958~1.000。结论血清CRP/PA比值、PCT/ALB比值、MCP-1和sICAM-1对IPN病情程度及预后具有高度诊断价值。Objective To explore the diagnostic value of the serum C-reactive protein(CRP)to prealbumin(PA)ratio,procalcitonin(PCT)to albumin(ALB)ratio,monocyte chemotactic protein-1(MCP-1),and soluble intercellular adhesion molecule-1(sICAM-1)in assessing the severity and prognosis of infectious pneumonia of the newborn(IPN).Methods A retrospective study was conducted on the clinical data of 146 IPN infants admitted to the Department of Neonatology,Xianyang Hospital of Yan′an University from January 2020 to January 2023.Patients were divided into severe(n=84)and non-severe(n=62)groups based on the severity of the condition,and into poor prognosis(n=44)and good prognosis(n=40)groups based on prognosis.Serum levels of CRP,PA,CRP/PA ratio,serum PCT and ALB levels,PCT/ALB ratio,and levels of MCP-1 and sICAM-1 were compared among groups.Pearson correlation analysis was used to analyze the correlation between CRP/PA ratio,PCT/ALB ratio,MCP-1,sICAM-1 levels,and the severity of IPN.Receiver operating characteristic(ROC)curve analysis was used to assess the diagnostic efficiency of serum levels of CRP,PA,CRP/PA ratio,serum PCT and ALB levels,PCT/ALB ratio,and levels of MCP-1 and sICAM-1 for the severity and prognosis of IPN.Results The levels of CRP,PCT,CRP/PA ratio,PCT/ALB ratio,MCP-1,and sICAM-1 were higher in the severe group than in the non-severe group,while PA and ALB levels were lower(P<0.05).Similarly,the levels of CRP,PCT,CRP/PA ratio,PCT/ALB ratio,MCP-1,and sICAM-1 were higher,while PA and ALB levels were lower in the poor prognosis group compared with the good prognosis group(P<0.05).Pearson analysis showed a positive correlation between the CRP/PA ratio,PCT/ALB ratio,MCP-1,sICAM-1 levels and the severity of IPN in children(P<0.05).ROC analysis indicated that the diagnostic value of serum sICAM-1 levels was the highest for the severity of NIP,with an AUC of 0.978(95%CI:0.956-1.000),and also the highest for prognosis,with an AUC of 0.981(95%CI:0.958-1.000).Conclusion The serum CRP/PA ratio,PCT/ALB ratio,MCP-1,and sICAM-1

关 键 词：肺炎 C反应蛋白质 前白蛋白 降钙素原 白蛋白 

分 类 号：R725.631[医药卫生—儿科]