联合检测C-反应蛋白 脂多糖结合蛋白 磷脂酰乙醇胺及磷脂酰丝氨酸在社区获得性肺炎患儿诊断病情判断与预后评估中的意义  

Significance of combined detection of C-reactive protein,lipopolysaccharide-binding protein,phosphatidyl ethanolamine,and phosphatidylserine in diagnosis,disease judgment,and prognosis evaluation of children with community-acquired pneumonia

作　　者：明学 胡忠华 王剑[1] MING Xue;HU Zhong-hua;WANG Jian(Department of Pediatrics,Linping Campus,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang 311100,China)

机构地区：[1]浙江大学医学院附属第二医院临平院区儿科,浙江杭州1311100

出　　处：《中国妇幼保健》2025年第7期1221-1225,共5页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2023XY010)。

摘　　要：目的 分析C-反应蛋白(CRP)、脂多糖结合蛋白(LBP)、磷脂酰乙醇胺(PE)及磷脂酰丝氨酸(PS)联合检测在社区获得性肺炎(CAP)患儿诊断、病情判断与预后评估中的意义。方法 选取2022年2月—2024年2月浙江大学医学院附属第二医院临平院区儿科收治的92例CAP患儿作为研究组,同期在院体检的50例健康儿童作为对照组。比较两组血清CRP、LBP、PE、PS水平。依据严重程度,将研究组患儿分为轻度组、重度组,比较两组血清CRP、LBP、PE、PS水平。分析CRP、LBP、PE、PS与CAP患儿病情严重程度的相关性。依据转归,将研究组患儿分为预后良好组、预后不良组,筛选影响CAP患儿预后的危险因素,并评估CRP、LBP、PE、PS联合检测预测CAP患儿预后的效能。结果 研究组CRP、LBP水平均高于对照组,PE、PS水平均低于对照组(均P<0.05)。重度组CRP、LBP水平均高于轻度组,PE、PS水平均低于轻度组(均P<0.05)。CRP、LBP水平与CAP患儿病情均呈正相关(r=0.762、0.602,均P<0.05),PE、PS水平与CAP患儿病情均呈负相关(r=-0.853、-0.852,均P<0.05)。预后不良组合并低氧血症、合并多重感染、初始抗菌联合用药率均高于预后良好组,CRP、LBP水平均高于预后良好组,PE、PS水平均低于预后良好组(均P<0.05)。合并低氧血症、合并多重感染、初始抗菌联合用药、CRP水平高、LBP水平高、PE水平低、PS水平低是CAP患儿预后不良的危险因素。CRP、LBP、PE、PS联合预测CAP患儿预后不良的灵敏度、准确度、曲线下面积(AUC)分别为92.45%、89.50%、0.923。结论 CAP患儿CRP、LBP水平异常升高,其水平与CAP严重程度呈正相关;PE、PS水平异常降低,其水平与CAP严重程度呈负相关。CRP、LBP、PE、PS联合检测对患儿不良预后具有一定预测价值。Objective To analyze the significance of combined detection of C-reactive protein(CRP),lipopolysaccharide-binding protein(LBP),phosphatidyl ethanolamine(PE),and phosphatidylserine(PS)in diagnosis,disease judgment,and prognosis evaluation of children with community-acquired pneumonia(CAP).Methods A total of 92 children with CAP admitted to Department of Pediatrics,Linping Campus,the Second Affliated Hospital of Zhejiang University School of Medicine from February 2022 to February 2024 were selected as study group,and 50 healthy children who underwent physical examination in the hospital during the same period were selected as control group,CRP,LBP,PE,and PS levels were compared between the two groups.According to severity of the disease,the children in study group were divided into mild group and severe group,the levels of CRP,LBP,PE,and PS in the two groups were compared.The correlations between CRP,LBP,PE,PS and severity of the disease in children with CAP were analyzed.The children in study group were divided into good prognosis group and poor prognosis group according to clinical outcomes,the risk factors of prognosis of children with CAP were screened,and the efficacy of combined of CRP,LBP,PE,and PS in predicting the prognosis of children with CAP was evaluated.Results The levels of CRP and LBP in study group were higher than those in control group,the levels of PE and PS were lower than those in control group,there were statistically significant differences(all P<0.05).The levels of CRP and LBP in severe group were higher than those in mild group,the levels of PE and PS were lower than those in mild group,there were statistically significant differences(all P<0.05).CRP and LBP were positively correlated with the disease of CAP children(r=0.762,0.602,P<0.05),PE and PS levels were negatively correlated with the disease of CAP children(r=-0.853,-0.852,P<0.05).The rates of children complicated with hypoxemia,multiple infection,and initial antimicrobial combination in poor prognosis group were higher than those

关 键 词：社区获得性肺炎 儿童 C-反应蛋白 脂多糖结合蛋白 磷脂酰乙醇胺 磷脂酰丝氨酸 

分 类 号：R725.6[医药卫生—儿科]