GDF-15联合cTnI对重症肺炎患儿心肌损伤早期诊断的价值

Value of GDF-15 combined with cTnI in early diagnosis of severe pneumonia children with myocardial damage

目的探讨生长分化因子-15(GDF-15)联合心肌肌钙蛋白1(c Tn I)对重症肺炎患儿心肌损伤早期诊断的价值,为预防和治疗提供参考资料。方法选取2017年1月-2018年7月医院收治的116例重症肺炎患儿作为研究对象,其中42例重症肺炎合并心肌损伤患儿为合并症组,74例未发生心肌损伤患儿为非合并症组,选取同期体检健康儿童60例作为对照组,采用ELISA法检测血清GDF-15、c Tn I水平,比较3组GDF-15、c Tn I水平,二者表达相关性及联合检测对重症肺炎合并心肌损伤患儿早期诊断价值。结果合并症组、非合并症组患儿血清GDF-15、c Tn I水平均高于对照组儿童,合并症组高于非合并症组,差异均有统计学意义(P<0.05)。合并症组患儿T0~T2血清GDF-15、c Tn I水平均高于非合并症组患儿,差异有统计学意义(P<0.05);合并症组患儿血清GDF-15与c Tn I表达呈正相关性(r=0.790,P=0.000)。ROC曲线分析显示,GDF-15的AUC为0.644,诊断灵敏度为69.05%,特异性为82.43%;c Tn I的AUC为0.854,诊断灵敏度为78.57%,特异性为85.14%;两指标联合检测的AUC为0.868,诊断敏感性为78.59%,特异性为89.19%。结论GDF-15、c Tn I在重症肺炎合并心肌损伤患儿血清中表达升高,二者表达呈正相关性,联合诊断的灵敏度、特异性高,可作为重症肺炎合并心肌损伤患儿早期诊断潜在检测指标。

Objective To explore the value of growth differentiation factor-15(GDF-15)combined with cardiac troponin 1(c Tn I)in early diagnosis of severe pneumonia children with myocardial damage,provide reference for prevention and treatment.Methods A total of116 children with severe pneumonia treated in Wuzhong People’s Hospital from January 2017 to July 2018 were selected and divided into complication group(42 children with severe pneumonia and myocardial damage)and non-complication group(42 children with severe pneumonia),60 healthy children receiving physical examination during the same period were selected as control group.ELISA was used to detect the levels of serum GDF-15 and c Tn I.The levels of GDF-15 and c Tn I in the three groups were compared.The correlation between GDF-15 and c Tn I,the early diagnostic value of joint detection of GDF-15 and c Tn I for severe pneumonia children with myocardial damage were analyzed.Results The levels of serum GDF-15 and c Tn I in complication group and non-complication group were statistically significantly higher than those in control group,the levels of serum GDF-15 and c Tn I in complication group were statistically significantly higher than those in non-complication group(P<0.05).The levels of serum GDF-15 and c Tn I at T0-T2 in complication group were statistically significantly higher than those in non-complication group(P<0.05).In complication group,serum GDF-15 expression was positively correlated with c Tn I expression(r=0.790,P=0.000).ROC curve analysis showed that AUC,diagnostic sensitivity,and specificity of GDF-15 were 0.644,69.05%,and 82.43%,respectively.AUC,diagnostic sensitivity,and specificity of c Tn I were 0.854,78.57%,and85.14%,respectively.AUC,diagnostic sensitivity,and specificity of joint detection of GDF-15 and c Tn I were 0.868,78.59%,and89.19%,respectively.Conclusion The expression levels of serum GDF-15 and c Tn I in children with severe pneumonia complicated with myocardial injury increase,there is a positive correlation between GDF-15 expression and c Tn I expression,the sensitivity and specificity of combined diagnosis are high,GDF-15 and c Tn I can be used as potential indexes for early diagnosis of severe pneumonia combined with myocardial injury in children.