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

Value of combining PCT, BNP, D-dimer and PCIS score in predicting the prognosis of severe pediatric pneumonia

目的评价早期联合血降钙素原(PCT)、脑钠肽(BNP)、D-二聚体(DD)以及PCIS评分在评估儿童重症肺炎预后中的价值。方法选取重症肺炎患儿80例作为研究对象,其中男49例、女31例,中位年龄7.5个月(1~156个月),根据患儿病情的最终转归分为治愈组和预后不良组;记录患儿入住儿童重症监护病房(PICU)24 h内的PCIS分值和PCT、BNP、DD数值,对上述指标绘制各自的受试者工作特征曲线(ROC曲线),比较各自的曲线下面积(AUC)。同时联合这四项指标绘制ROC曲线,并与各单独指标的AUC比较,评价联合诊断的优劣。结果入住PICU 24 h内的PCT、BNP、DD水平及PCIS各自的AUC均介于0.7~0.9之间,而联合这四种指标的ROC曲线的AUC为0.932,灵敏度和特异度均有所提高。结论联合PCIS评分、BNP、降钙素原、DD水平可以提高对儿童重症肺炎预后评估的准确率。

Objective To evaluate the value of combining PCT,BNP,D-Dimer and PCIS score in predicting the prognosisof pediatric severe pneumonia in the early stage.Methods80cases of children with severe pneumonia were selected,49caseswere boys,31cases were girls,with a median age of7.5months(1month to156months).According to the final outcome,thecases are divided into treatment group and poor prognosis group.The score of PCIS,PCT,BNP and D-dimer within24hoursafter admission were recorded.According to the indicators,ROC curve was drawn independently and integrated with the fourindicators,and the corresponding areas under ROC curve(AUC)were calculated to compare the accuracy of the assessment.Results The AUC of PCIS,PCT,BNP and D-dimer were between0.7and0.9.The ROC curve integrated the four indicatorsshowed the AUC were0.932,which improved sensitivity and specificity.Conclusions The integration of PCIS,PCT,BNP andD-Dimer could improve the accuracy of prediction in the prognosis of severe pediatric pneumonia.