细菌感染性肺炎新生儿血清IL-6与PCT和hs-CRP的表达及诊断价值研究

Diagnostic value of serum IL-6,PCT and hs-CRP expression in newborn with bacterial pneumonia

目的探究血清白细胞介素-6(IL-6)、降钙素原(PCT)和超敏C-反应蛋白(hs-CRP)的检测在新生儿细菌感染性肺炎诊断中的意义。方法选取2015年4月-2018年2月经宜昌市第二人民医院诊治的肺炎新生儿150例,根据细菌感染情况分为细菌感染组78例和非细菌感染组72例;另选同期出生的75例健康新生儿作为对照组。比较三组新生儿入院时的血清IL-6、PCT和hs-CRP水平。采用受试者操作特征(ROC)曲线分析血清IL-6、PCT、hs-CRP在诊断新生儿细菌感染性肺炎中的价值。结果入院时,细菌感染组患儿的IL-6、PCT和hs-CRP分别为(253.46±53.25)pg/ml、(2.23±1.21)ng/ml、(23.46±2.87)mg/L高于非细菌感染组(19.42±10.24)pg/ml、(0.81±0.76)ng/ml、(9.75±2.35)mg/L和对照组(P<0.05);血清hs-CRP诊断新生儿细菌感染性肺炎的灵敏度、特异度分别为79.49%、84.62%高于IL-6(P<0.05),血清PCT诊断新生儿细菌感染性肺炎的灵敏度、特异度分别为83.33%、88.46%高于hs-CRP(P<0.05),但PCT、IL-6联合hs-CRP诊断新生儿细菌感染性肺炎的灵敏度、特异度分别为92.31%、93.59%高于IL-6、PCT和hs-CRP(P=0.05),IL-6诊断新生儿细菌感染性肺炎的ROC曲线下面积(AUC)为0.821(95%CI:0.683~0.864),PCT的AUC为0.857(95%CI:0.742~0.908),hs-CRP的AUC为0.838(95%CI:0.704~0.885),IL-6、PCT联合hs-CRP的AUC为0.893(95%CI:0.783~0.952)优于单独检测(P<0.05)。结论IL-6、PCT和hs-CRP在新生儿细菌感染性肺炎患儿血清中的水平均升高,均在新生儿细菌感染性肺炎诊断中具有较好的效能,但PCT、IL-6联合hs-CRP的诊断价值更高。

OBJECTIVE To investigate the significance of serum interleukin-6(IL-6),procalcitonin(PCT)and hypersensitive C-reactive protein(hs-CRP)in the diagnosis of neonatal bacterial pneumonia.METHODS 150 cases of diagnosed neonatal bacterial pneumonia in our hospital from Apr.2015 to Feb.2018 were selected and divided into bacterial infection group(78 cases)and non-bacterial infection group(72 cases),respectively,according to the bacterial infection.Another 75 healthy newborns born at the same time were chosen as a control group.Serum IL-6,PCT and hs-CRP levels of patients at admission were compared among three groups.Receiver operating characteristic curve(ROC curve)were used to analyze the diagnositic value serum IL-6,PCT andhs-CRP in neonatal bacterial pneumonia.RESULTS At admission,the levels of IL-6,PCT and hs-CRP of children with bacterial infection were(253.46±53.25)pg/ml,(2.23±1.21)ng/ml and(23.46±1.21)ng/ml,respectively,significantly higher than those of non-bacterial infection group(19.42±10.24)pg/ml,(0.81±0.76)ng/ml,and(9.75±2.35)mg/L,respectively.and diagnosis of neonatal bacteria The sensitivity and specificity of hs-0.05-hs-CRP in diagnosing neonatal bacteria pneumonia were 79.49%and 84.62%,significantly higher than that of IL-6(P<0.05).The sensitivity and specificity of serum PCT in diagnosis of neonatal bacterial pneumonia were 83.33%and 88.46%,respectively,higher than hs-CRP(P<0.05).Whereas the sensitivity and specificity of PCT and IL-6 combined with hs-CRP in diagnosis of neonatal bacterial pneumonia were 92.31%and 93.59%,respectively,significantly higher than those of IL-6,PCT and hs-CRP(P<0.05).The area under ROC curve(AUC)of IL-6 was 0.821(95%CI:0.683~0.864),the AUC of PCT was 0.857(95%CI:0.742~0.908),the AUC of hs-CRP was 0.838(95%CI:0.704~0.885),respectively,while the AUC of IL-6 combined with PCT and hs-CRP was 0.893(95%CI:0.783~0.952),significantly better than that of the single detection(P<0.05).CONCLUSION The levels of serum IL-6,PCT and hs-CRP in patients with neonatal bacterial pneumonia are significantly elevated,and exhibited good efficacy in the diagnosis of neonatal bacterial pneumonia,however,the combined value of hs-CRP,PCT and IL-6 is more valuable.