血D-二聚体等指标对重症肺部感染儿童生存状况的预测效果

Predictive effect of indexes including blood D-dimer on survival of children with severe pulmonary infection

目的探讨血D-二聚体(DD)、N末端脑钠素原(NT-ProBNP)、降钙素原(PCT)以及白细胞介素-6(IL-6)对重症肺部感染儿童生存状况的预测效果,旨在提高重症肺部感染儿童的生存率。方法选取2014年1月至2018年10月于宁波市妇女儿童医院接受治疗的54例重症肺部感染儿童为研究对象,按照生存与否将所有儿童分为两组,对照组为生存儿童共34例,观察组为死亡儿童,共20例,比较两组儿童的DD、NT-ProBNP、PCT以及IL-6等指标,使用多因素logisitic回归分析威胁重症肺部感染儿童生存的危险因素。结果观察组DD水平为(2.36±0.44)μg/mL,NT-ProBNP水平为(3127.92±312.86)pg/mL,对照组DD水平为(0.91±0.27)μg/mL,NT-ProBNP水平为(1362.55±115.74)pg/mL,差异具有统计学意义(t值分别为2.089、2.011,均P<0.05);观察组PCT水平为(1.47±0.32)ng/mL,IL-6水平为(65.27±6.88)pg/mL,对照组PCT水平为(0.44±0.13)ng/mL,IL-6水平为(8.95±1.36)pg/mL,差异具有统计学意义(t 值分别为2.207、2.281,均P<0.05);多因素logisitic回归分析显示高DD水平、高NT-ProBNP、高PCT水平以及高IL-6水平是威胁重症肺部感染儿童生存的高危险因素。结论 DD、NT-ProBNP、PCT与IL-6可以用于预测重症肺部感染儿童的生存状况,高DD、NT-ProBNP、PCT与IL-6提示儿童有死亡风险,临床上应该加以重视。

Objective To explore the predictive effect of blood D-dimer(DD), N-terminal pro-brain natriuretic(NT-ProBNP), procalcitonin(PCT) and interleukin(IL)-6 on the survival of children with severe pulmonary infection, aiming to improve the survival rate of children with severe pulmonary infection. Methods Fifty-four children with severe pulmonary infection who were treated in Ningbo Women and Children Hospital from January 2014 to October 2018 were selected as subjects. According to the survival or not, all children were divided into two groups. The control group was living child(34 cases), and the observation group was dead child(20 cases). Indexes including DD, NT-ProBNP, PCT, and IL-6 were compared between two groups. Multivariate Logistic regression was used to analyze risk factors for survival of children with severe pulmonary infection. Results In the observation group, the levels of DD and NT-ProBNP were(2.36±0.44)μg/mL and(3 127.92±312.86)pg/mL, respectively, while in the control group, they were(0.91±0.27) μg/mL and(1 362.55±115.74)pg/mL, respectively with significant differences(t value was 2.089 and 2.011, respectively, both P<0.05). The PCT and IL-6 levels of the observation group were(1.47±0.32)ng/mL and(65.27±6.88)pg/mL, respectively, and those of the control group were(0.44±0.13)ng/mL and(8.95±1.36) pg/mL, respectively(t value was 2.207 and 2.281, respectively, both P<0.05). Multivariate Logistic regression analysis showed that high DD level, high NT-ProBNP, high PCT level, and high IL-6 level were risk factors for children with severe pulmonary infection. Conclusion DD, NT-ProBNP, PCT and IL-6 can be used to predict the survival of children with severe pulmonary infection. High DD, NT-ProBNP, PCT and IL-6 levels suggest that children have a risk of death and should be taken clinically.