血清C反应蛋白、正五聚蛋白-3对小儿肺动脉高压的诊断价值

Diagnostic Value of Serum c-reactive Protein and Pentraxin-3 for the Children with Severe Pulmonary Hypertension

目的:研究血清C反应蛋白(CRP)和正五聚蛋白-3(PTX-3)在小儿肺动脉高压(PAH)诊断中的临床价值。方法:选择32例PAH患儿及32例健康小儿,检测和比较其血清CRP、PTX-3水平,分析血清CRP、PTX-3水平的相关性,通过绘制ROC曲线评价其对于PAH的诊断价值。结果:PAH组血清CRP水平(29.63±15.82 mg/L)、PTX-3水平(1.20±1.03 ng/m L)与对照组[CRP水平(3.38±1.74 mg/L)、PTX-3水平(0.64±0.43 ng/m L)]相比均显著升高(P<0.01)。血清CRP与PTX-3的相关系数r为0.356(P<0.05)。血清CRP诊断PAH的ROC曲线AUC为0.983,临界点为6.6 mg/L;PTX-3诊断PAH的ROC曲线AUC为0.669,临界点为0.95ng/m L;两者联合诊断的AUC为0.986,临界点为1.01。结论:PAH患儿血清PTX-3和CRP水平均显著升高,CRP大于PTX对PAH的诊断价值,两者联合诊断的价值更大。

Objective： To research the clinical value of serum c-reactive protein（CRP） and pentraxin-3（PTX-3） for the diagnosis of children with pulmonary hypertension（PAH）. Methods： 32 cases of children with PAH and 32 cases of normal children were chosen.The serum levels of CRP and PTX-3 were detected and compared between two groups, the correlation between CRP and PTX-3 was also assessed. Diagnostic value was evaluated by ROC curve. Results： The serum levels of CRP（29.63±15.82 mg/L） and PTX-3（3.38±1.74 mg/L） in PAH group were significantly higher than those of the control group respectively [CRP level（1.20±1.03 ng/m L） and PTX-3 level（0.64±0.43 ng/m L）, P〈0.01]. Correlation coefficient was 0.335（P〈0.05） between CRP and PTX-3 in serum. With ROC curve for diagnosis of PAH, AUC of CRP was 0.983（P〈0.05）, and cut off point was 6.6 mg/L. AUC of PTX-3 was 0.669（P〈0.05）, cut off point was0.95 ng/m L. AUC of combination of CRP and PTX-3 was 0.986, cut off point was 1.01. Conclusions： Upregulation of serum levels of CRP and PTX-3 were found in children with PAH. The diagnostic value of CRP was better than PTX-3 for PAH. Meanwhile, the combination of serum levels of CRP and PTX-3 had better diagnostic value for children with PAH.