[1]宋道兵.血清降钙素原、B型钠尿肽和白细胞三烯B4水平对儿童重症肺炎的诊断价值[J].新乡医学院学报,2020,37(5):453-455.[doi:10.7683/xxyxyxb.2020.05.013]
　SONG Daobing.Diagnostic value of serum procalcitonin,B-type natriuretic peptide and leukotriene B4 in children with severe pneumonia[J].Journal of Xinxiang Medical University,2020,37(5):453-455.[doi:10.7683/xxyxyxb.2020.05.013]
点击复制

血清降钙素原、B型钠尿肽和白细胞三烯B4水平对儿童重症肺炎的诊断价值
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年5
页码:
453-455
栏目:
临床研究
出版日期:
2020-05-05

文章信息/Info

Title:
Diagnostic value of serum procalcitonin,B-type natriuretic peptide and leukotriene B4 in children with severe pneumonia
作者:
宋道兵
（随州市妇幼保健院儿内科，湖北　随州　441300）
Author(s):
SONG Daobing
(Department of Pediatrics,Suizhou Maternal and Child Health Hospital,Suizhou 441300,Hubei Province,China)
关键词:
肺炎; B型钠尿肽; 降钙素原; 白细胞三烯B4; 诊断价值; 儿童
Keywords:
severe pneumonia; B-type natriuretic peptide; procalcitonin; leukotriene B4; diagnostic value; children
分类号:
R563.1
DOI:
10.7683/xxyxyxb.2020.05.013
文献标志码:
A
摘要:
目的　探讨血清降钙素原（PCT）、B型钠尿肽（BNP）和白细胞三烯B4（LTB4）水平对儿童重症肺炎的诊断价值。方法　选择2017年3月至2019年3月随州市妇幼保健院收治的128例肺炎患儿为研究对象，根据病情严重程度分为轻度肺炎组和重度肺炎组，每组64例。所有患儿于入院后第2天采集清晨空腹静脉血5 mL，采用酶联荧光分析法检测血清PCT、LTB4水平，采用微粒子酶促化学发光法检测血清BNP水平；对2组患儿血清PCT、BNP、LTB4水平进行比较，并采用受试者工作特征（ROC）曲线分析血清PCT、BNP、LTB4单独及三者联合检测对儿童重症肺炎的诊断价值。结果　重度肺炎患儿血清PCT、BNP、LTB4水平显著高于轻度肺炎患儿（P<0.05）。ROC曲线显示，血清PCT、BNP、LTB4诊断儿童重症肺炎的临界值分别为1.26 μg·L-1、385.23 ng·L-1、124.55 ng·L-1，曲线下面积（AUC）分别为0.893、0.786、0.773，特异性分别为85.94%、67.19%、70.31%，敏感性分别为82.81%、67.19%、70.31%；三者联合检测诊断儿童重症肺炎的AUC、特异性、敏感性分别为0.926、96.88%、95.31%；血清PCT水平诊断儿童重症肺炎的AUC、特异性、敏感性大于血清BNP和LTB4（P<0.05），血清BNP、LTB4诊断儿童重症肺炎的AUC、特异性、敏感性比较差异无统计学意义（P>0.05），血清PCT、BNP、LTB4联合检测诊断儿童重症肺炎的AUC、特异性、敏感性大于三者单独检测（P<0.05）。结论　儿童重症肺炎患儿血清PCT、BNP、LTB4水平升高，血清PCT对儿童重症肺炎的诊断价值优于血清BNP和LTB4，三者联合检测对儿童重症肺炎的诊断价值大于三者单独检测。
Abstract:
Objective　To investigate the diagnostic value of serum procalcitonin (PCT),B-type natriuretic peptide (BNP) and leukotriene B4 (LTB4) levels in children with severe pneumonia.Methods　A total of 128 children with pneumonia admitted to Suizhou Maternal and Child Health Hospital from March 2017 to March 2019 were selected as the study subjects and they were divided into mild pneumonia group and severe pneumonia group according to the severity of the disease,with 64 cases in each group.On the second day after admission,5 mL fasting venous blood of all children was collected in the morning,the serum PCT and LTB4 levels were detected by enzyme-linked fluorescence analysis,and the serum BNP level was detected by micropartical chemiluminescence immunoassay.The levels of serum PCT,BNP and LTB4 were compared between the two groups,and the diagnostic value of serum PCT,BNP and LTB4 levels in children with severe pneumonia was analyzed by receiver operating characteristic (ROC) curve.Results　The levels of serum PCT,BNP and LTB4 in children with severe pneumonia were significantly higher than those in children with mild pneumonia (P<0.05).ROC curve showed that the critical value of serum PCT,BNP and LTB4 for the diagnosis of severe pneumonia in children was 1.26 μg·L-1,385.23 ng·L-1 and 124.55 ng·L-1,respectively;the AUC was 0.893,0.786 and 0.773,respectively;the specificity was 85.94%,67.19% and 70.31%,respectively;and the sensitivity was 82.81%,67.19% and 70.31%,respectively.The AUC,specificity and sensitivity of the combined detection of serum PCT,BNP and LTB4 for the diagnosis of severe pneumonia in children were 0.926,96.88% and 95.31%,respectively.The AUC,specificity and sensitivity of serum PCT in diagnosis of severe pneumonia in children were higher than those of serum BNP and LTB4 (P<0.05).There was no significant difference in the AUC,specificity and sensitivity of serum BNP and LTB4 in the diagnosis of severe pneumonia in children (P>0.05).The AUC,specificity and sensitivity of the combined detection of serum PCT,BNP and LTB4 in diagnosis of severe pneumonia in children were higher than those of the separately detection of them(P<0.05).Conclusion　The levels of serum PCT,BNP and LTB4 are increased in children with severe pneumonia.The diagnostic value of serum PCT in children with severe pneumonia is better than that of serum BNP and LTB4,the diagnostic value of the combined detection of them is greater than that of the single detection.

参考文献/References:

［1］　WAHL B,SHARAN A,DELORIA KNOLL M,et al.National,regional,and state-level burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in India:modelled estimates for 2000-15［J］.Lancet Glob Health,2019,7(6):e735-e747.
［2］　汪东海，陈建川，田代印，等.儿童EB病毒致传染性单核细胞增多症并肺炎的危险因素［J］.中华实用儿科临床杂志，2019，34（22）：1698-1701.
［3］　荆小袁，陆敏.儿童重症肺炎支原体肺炎的高危因素分析［J］.上海医学，2019，42（1）：27-31.
［4］　中华医学会儿科学分会呼吸学组，《中华儿科杂志》编辑委员会.儿童社区获得性肺炎管理指南：2013修订［J］.中华儿科杂志，2013，51（10）：745-752.
［5］　DERSEH B,MRUTS K,DEMIE T,et al.Co-morbidity,treatment outcomes and factors affecting the recovery rate of under-five children with severe acute malnutrition admitted in selected hospitals from Ethiopia:retrospective follow up study［J］.Nutr J,2018,17(1):116-123.
［6］　杜开先，张华玲，李曼曼，等.病毒性脑炎及细菌性脑膜炎患儿血清及脑脊液血管内皮细胞钙黏蛋白、降钙素原的变化及意义［J］.中华实用儿科临床杂志，2019，34（18）：1407-1410.
［7］　郝青，刘义庆.PCT、WBCN%、CRP、ESR、血培养、痰培养联合检测在儿科重症肺炎中的应用［J］.中国妇幼保健，2018，33（16）：3706-3708.
［8］　许巍.儿童肺炎支原体肺炎与呼吸衰竭［J］.中华实用儿科临床杂志，2018，33（12）：887-891.
［9］　NASCIMENTO-CARVALHO A C,NASCIMENTO-CARVALHO C M.Clinical management of community-acquired pneumonia in young children［J］.Expert Opin Pharmacother,2019,20(4):435-442.
［10］　吴述光，侯小丽，马胜喜.重症肺炎并发脓毒症患者血清高迁移率族蛋白B1检测的临床意义［J］.新乡医学院学报，2018，35（2）：143-145，150.
［11］　郭玮，何煜婷，邵琦，等.联合血降钙素原、脑钠肽、D-二聚体及PCIS评分对评估儿童重症肺炎预后的价值［J］.临床儿科杂志，2017，35（8）：575-579.
［12］　杨丽敏，衡伟，林桂花.联合检测PCT与BNP水平对重症肺炎的临床诊治意义评价［J］.中国处方药，2016，14（12）：119-120.
［13］　ACCIO S,MANDOMANDO I,NHAMPOSSA T,et al.Risk factors for death among children 0-59 months of age with moderate-to-severe diarrhea in Manhica district,southern Mozambique［J］.BMC Infect Dis,2019,19(1):322-335.
［14］　李蜀，李贝.盐酸氨溴索静脉滴注联合雾化吸入治疗新生儿肺炎疗效及对血气指标、血清LTB4和PCT水平的影响［J］.赣南医学院学报，2018，38（6）：552-554，598.
［15］　付红敏，聂文莎.儿童重症肺炎的早期识别［J］.中国实用儿科杂志，2018，33（9）：691-695.

相似文献/References:

[1]李玉洁.1,6-二磷酸果糖辅助治疗小儿肺炎并心力衰竭疗效观察[J].新乡医学院学报,2009,26(01):083.
[2]崔长富,谷　娟,李转会,等. 综合康复治疗对急性脑卒中后吞咽障碍及卒中相关性肺炎的影响[J].新乡医学院学报,2015,32(08):782.
[3]张　华.不同病原体感染肺炎患儿支气管肺泡灌洗液中肺表面活性物质相关蛋白的表达[J].新乡医学院学报,2017,34(6):510.[doi:10.7683/xxyxyxb.2017.06.015]
　ZHANG Hua.Expression of pulmonary surfactant associated protein in bronchoalveolar lavage fluid of children with pneumonia caused by different pathogens[J].Journal of Xinxiang Medical University,2017,34(5):510.[doi:10.7683/xxyxyxb.2017.06.015]
[4]付君静,李春凤.替加环素治疗多重或泛耐药鲍曼不动杆菌肺炎疗效观察[J].新乡医学院学报,2016,33(6):504.[doi:10.7683/xxyxyxb.2016.06.016]
　FU Jun-jing,LI Chun-feng.Clinical efficacy of tigecycline in the treatment of the pneumonia caused by multidrug resistant/extensively drug-resistant acinetobacter baumanni[J].Journal of Xinxiang Medical University,2016,33(5):504.[doi:10.7683/xxyxyxb.2016.06.016]
[5]安　阳,王　莉,张俊迪,等.多重耐药菌感染肺炎老年患者外周血中微RNA-127-5p水平与辅助性T细胞和调节性T细胞及其细胞因子的相关性[J].新乡医学院学报,2021,38(11):1053.[doi:10.7683/xxyxyxb.2021.11.010]
　AN Yang,WANG Li,ZHANG Jundi,et al.Correlation between the levels of microRNA-127-5p in peripheral blood and helper T cells,regulator T cells and their cytokines in elderly patients with pneumonia infected by multidrug resistant organism[J].Journal of Xinxiang Medical University,2021,38(5):1053.[doi:10.7683/xxyxyxb.2021.11.010]
[6]蒋国路,李奉玲,宁　东,等.微小核糖核酸在肺部感染性疾病诊断中的研究进展[J].新乡医学院学报,2018,35(2):158.[doi:10.7683/xxyxyxb.2018.02.020]
　N/A.N/A[J].Journal of Xinxiang Medical University,2018,35(5):158.[doi:10.7683/xxyxyxb.2018.02.020]
[7]唐晓燕,郭喜霞,徐亚丽,等.豫北儿童诊疗中心肺炎住院患儿细菌病原学分析[J].新乡医学院学报,2016,33(5):411.[doi:10.7683/xxyxyxb.2016.05.018]
　TANG Xiao-yan,GUO Xi-xia,XU Ya-li,et al.Etiology analysis of bacterial etiology in the hospitalized children with pneumonia from children′s medical center in Northern Henan[J].Journal of Xinxiang Medical University,2016,33(5):411.[doi:10.7683/xxyxyxb.2016.05.018]

更新日期/Last Update: 2020-05-05