降钙素原、白介素-6在小儿呼吸道感染疗效及预后评估中的价值

The application value of procalcitonin and interleukin-6 in the evaluation of curative effect and prognosis of children with respiratory tract infection

目的探讨降钙素原(PCT)、白介素(IL)-6在小儿呼吸道感染疗效及预后评估中的价值。方法选取2019年1月至2021年4月收治的76例呼吸道感染患儿,分为细菌感染组36例和病毒感染组40例,另选取健康儿童40例为对照组,测定外周血PCT、IL-6水平变化,并进行数据分析。结果细菌感染组血清PCT、IL-6水平均明显高于对照组、病毒感染组,差异有统计学意义(P<0.05);病毒感染组与对照组血清PCT、IL-6水平的差异均无统计学意义(P>0.05);细菌性感染患儿予以规范化治疗后,显效22例(61.11%)、有效8例(22.22%)、无效6例(16.67%),总有效率为83.33%,其中显效、有效患儿血清PCT、IL-6水平均显著降低(P<0.05),而无效组患儿血清PCT、IL-6无明显变化(P>0.05);ROC曲线结果显示,血清PCT、IL-6水平及联测检测的AUC依次为0.753、0.709、0.848,PCT、IL-6最佳截断值取0.836、20.461时1.238时,其对应的敏感度为67.46%、72.37%,特异度为76.40%、85.61%,二者联合检测对临床有效的预测敏感度、特异度为88.94%、91.43%。结论血清PCT、IL-6可用于小儿细菌性呼吸道感染的临床诊断,二者对临床治疗效果的应答良好,对小儿呼吸道感染的预后评估具有较高的参考价值,值得进一步探讨。

Objective To investigate the application value of procalcitonin(PCT)and interleukin(IL-6)in the evaluation of curative effect and prognosis of children with respiratory tract infection.Methods A total of 76 children with respiratory tract infections who were treated in our hospital from January 2019 to April 2021 were enrolled in the study,who were divided into bacterial infection group(n=36)and viral infection group(n=40),at the same time,the other 40 healthy children were enrolled as control group.The therapeutic effects and the changes of serum levels of PCT and IL-6 were observed and compared between the two groups.Results The serum levels of PCT and IL-6 in bacterial infection group were significantly higher than those in control group and those in viral infection group(P<0.05),however,there were no significant differences in serum levels PCT and IL-6 between viral infection group and control group(P>0.05).After standardized treatment for the children with bacterial infection,22 cases were markedly effective(61.11%),8 cases were effective(22.22%),and 6 cases were ineffective(16.67%),with the total effective rate being 83.33%,of whom,the serum levels of PCT and IL-6 in obvious effects groups were significantly decreased(P<0.05),however,which in ineffective group had no significant changes(P>0.05).The ROC curve results showed that the serum levels of PCT and IL-6 combined with AUC were 0.753,0.709,0.848,respectively.When the best cut-off values of PCT and IL-6 were 0.836 and 20.461 at 1.238,the corresponding sensitivities were 67.46%and 72.37%,and the specificities were 76.40%and 85.61%,and the sensitivity and specificity by combined detection of the two indexes were 88.94%and 91.43%.Conclusion The detection of serum levels of PCT and IL-6 is of important significance in evaluating the therapeutic effects and prognosis of children with respiratory tract infection.