H-FABP、NT-proBNP、hs-CRP及PCT检测在儿童肺炎支原体肺炎中的临床意义

Clinical significance of H-FABP,NT-proBNP,hs-CRP and PCT detection for children with Mycoplasma pneumoniae pneumonia

目的探讨心型脂肪酸结合蛋白(H-FABP)、氨基末端脑利钠肽前体(NT-proBNP)、血清超敏C反应蛋白(hs-CRP)及前降钙素原(PCT)联合检测在肺炎支原体(MP)肺炎病情评估中的意义。方法将徐州医科大学附属医院儿科收治的125例肺炎患儿按病原学分为支原体肺炎组(MPP组)及普通支气管肺炎组(CP组)。根据病情严重程度将MPP组分为轻症组(CMPP组)和重症组(SMPP组),同期选取正常儿童50例作为对照组。各组均行血清NT-proBNP、H-FABP、PCT和hs-CRP检测,比较各指标在各组间的差异。采用ROC曲线分析联合检测对MPP病情的评估效能。结果SMPP组、CMPP组和CP组hs-CRP、PCT、NT-proBNP及HFABP水平均显著高于对照组,SMPP组高于CMPP组和CP组,差异有统计学意义(P<0.01);CMPP组H-FABP水平显著高于CP组,差异有统计学意义(P<0.01)。NT-proBNP、H-FABP、PCT和hs-CRP单项指标评估MPP病情时,ROC曲线下面积(AUC)分别为0.815、0.787、0.739和0.732。hs-CRP与PCT联合检测AUC为0.815,NT-proBNP与H-FABP联合检测AUC为0.870。将4项指标联合检测时,其AUC最大(AUC=0.957),灵敏度最高(96%),特异度为86%。结论NT-proBNP、H-FABP、PCT和hs-CRP在MPP病情评估中均具有一定的临床价值。4项指标联合检测可提高对MPP病情严重程度的评估效能。

Objective To discuss the application of combined detection of heart-type fatty acid-binding proteins(H-FABP),N-terminal pronatriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP)and procalcitonin(PCT)in evaluating Mycoplasma pneumoniae pneumonia(MPP).Methods A total of 125 children with pneumonia who were admitted into our hospital were enrolled.According to etiological results,they were divided into two groups:a Mycoplasma pneumonia pneumonia(MPP)group and a common bronchopneumonia(CP)group.According to disease severity,the MPP group was divided into a mild disease(CMPP)group and a severe disease(SMPP)group.Meanwhile,50 healthy children were selected as a control group.Each group was detected for the levels of serum NT-proBNP,H-FABP,PCT and hs-CRP,and the difference of each indicator among each group was compared.ROC curve analysis was used to evaluate the efficacy of combined detection for MPP.Results The levels of H-FABP,NT-proBNP,hs-CRP and PCT in the SMPP,CMPP and CP groups were remarkably higher than those in the control group(P<0.01),while the SMPP group produced increased levels compared with the CMPP and CP Groups(P<0.01).The level of H-FABP in the CMPP group was higher than that of the CP group(P<0.01).The area under the ROC curve(AUC)was 0.815 for NT-proBNP,0.787 for H-FABP,0.739 for PCT and 0.743 for hs-CRP.The AUC was 0.815 when combined use of hs-CRP and PCT,and was 0.870 when combined use of NT-proBNP and HFABP.When combined use of all four indicators,the AUC was the largest(AUC=0.957),the sensitivity was the highest(96%),and the specificity was 86%.Conclusions NT-proBNP,H-FABP,PCT and hs-CRP have certain clinical values to evaluate MPP disease.The combined use of all the four indicators can improve the evaluation efficiency of MPP severity.