外周血和尿锌浓度对儿童细菌性重症肺炎病情评估的临床研究

Detection of Peripheral Blood and Urine Zinc Levels in Children with Severe Bacterial Pneumonia

目的:探讨外周血和尿锌浓度检测对儿童细菌性重症肺炎病情评估的临床价值。方法:选取2013年1月-2015年12月本院诊断并治愈的重症肺炎儿童104例为观察组,另选取同期轻症肺炎儿童122例为对照组,均在治疗前、中、后期检测血锌、尿锌浓度,比较两组不同时期的血锌、尿锌浓度以及血锌、尿锌浓度变化时临床表现改善情况,并分析血锌、尿锌的诊断价值。结果:治疗中,观察组血锌浓度低于对照组(P<0.05),两组发热消退和咳嗽好转者比较差异均有统计学意义(P<0.05),但两组喘息缓解和进食增加者比较差异均无统计学意义(P>0.05);治疗后,观察组尿锌浓度低于对照组(P<0.05),两组发热消退、咳嗽好转、喘息缓解、进食增加者比较差异均无统计学意义(P>0.05);血锌ROC曲线下面积为0.90,大于尿锌的0.58(P<0.05);血锌敏感度为88.9%,高于尿锌的42.2%(P<0.05);血锌特异性为48.7%,高于尿锌的45.7%,但比较差异无统计学意义(P>0.05)。结论:血锌和尿锌浓度可有效评估儿童细菌性重症肺炎病程,对于细菌性重症肺炎血锌灵敏度优于尿锌测定,可作为儿童细菌性重症肺炎病情评估的有效指标之一。

Objective:To explore the clinical value of detection of peripheral blood and urine Zinc levels in children with severe bacterial pneumonia.Method:104 children with severe pneumonia diagnosed and cured in our hospital from January 2013 to December 2015 were selected as observation group and 122 children with mild pneumonia were selected as control group.The serum Zinc and urine Zinc concentration were detected before,during and after treatment.The serum and urine Zinc concentrations of two groups were compared,the improvement of clinical performance when blood and urine Zinc concentration changed of two groups were compared,and the diagnostic value of serum and urine Zinc was analyzed.Result:During treatment,the serum Zinc concentration in observation group was lower than that of control group(P<0.05),the fever subsided and cough improved in two groups were compared,the differences were statistically significant(P<0.05),but wheezing relief and eating increase in two groups were compared,the differences were not statistically significant(P>0.05).After treatment,the urine Zinc concentration in observation group was lower than that of control group(P<0.05),the fever subsided,cough improved,wheezing relief and eating increase in two groups were compared,the differences were not statistically significant(P>0.05).The area under the ROC curve of serum Zinc was 0.90,which was higher than 0.58 of urine Zinc(P<0.05),the sensitivity of serum Zinc was 88.9%,which was higher than 42.2%of urine Zinc(P<0.05),the specificity of serum Zinc was 48.7%,which was higher than 45.7%of urine Zinc,but the difference was not statistically significant(P>0.05).Conclusion:Detection of serum and urine Zinc concentration can effectively evaluate the course of severe bacterial pneumonia in children,and the sensitivity of serum Zinc for severe bacterial pneumonia is better than that of urine Zinc determination.It can be used as an effective index for evaluating the condition of severe bacterial pneumonia in children.