降钙素原、C-反应蛋白、脑钠肽、D-二聚体对小儿重症肺炎预后的评估价值

Value of procalcitonin,C-reactive protein,brain natriuretic peptide,and D-dimer in evaluating the prognosis of severe pneumonia in children

目的探讨血清降钙素原(PCT)、脑钠肽(BNP)、C-反应蛋白(CRP)和D-二聚体(DD)对小儿重症肺炎预后的评估价值。方法选取2019年1月至2021年1月泰安市妇幼保健院接收的重症肺炎患儿84例作为观察组,同期选取非重症肺炎患儿84例作为对照组,回顾性分析两组的临床资料,以PCT、BNP、CRP和DD为研究指标,对治疗前后患儿各指标水平情况分析,评估PCT、BNP、CRP和DD对小儿重症肺炎预后情况。结果治疗后,对照组的CRP(65.28±15.59)mg/L、PCT(0.77±0.15)μg/L、DD(1.90±0.31)mg/L、BNP(79.17±15.65)pg/ml,均低于观察组的CRP(144.33±16.61)mg/L、PCT(1.89±0.41)μg/L、DD(4.40±0.29)mg/L、BNP(549.91±16.79)pg/ml(P<0.05)。观察组患儿经治疗后,6例死亡,78例存活。死亡患儿的CRP(151.88±16.75)mg/L、PCT(2.53±0.29)μg/L、DD(4.61±0.66)mg/L、BNP(526.46±31.99)pg/ml,均高于存活患儿的CRP(99.63±15.99)mg/L、PCT(1.35±0.31)μg/L、DD(2.88±0.61)mg/L、BNP(89.41±22.27)pg/ml(P<0.05)。AUC相对偏高,根据临界值,说明有较高诊断效能。结论在诊断重症肺炎患儿及预测预后方面,CRP和PCT、DD和BNP指标水平应用价值高,且临床检验便捷,能对预警信息及时提供,使救治成功率提升。

Objective To explore the value of serum procalcitonin(PCT),brain natriuretic peptide(BNP),C-reactive protein(CRP),and D-dimer(DD)in the prognosis of children with severe pneumonia.Methods A total of 84 children with severe pneumonia admitted to Tai′an Maternity and Child Health Hospital from January 2019 to January 2021 were selected as the observation group.Another 84 children without severe pneumonia during the same period were selected as the control group.The clinical data of the two groups were retrospectively analyzed.PCT,BNP,CRP,and DD were used as the study indicators.The levels of each indicator before and after treatment were analyzed.The prognosis of PCT,BNP,CRP and DD for severe pneumonia in children was evaluated.Results After treatment,CRP(65.28±15.59)mg/L,PCT(0.77±0.15)μg/L,DD(1.90±0.31)mg/L and BNP(79.17±15.65)pg/ml in the control group were lower than those[CRP(144.33±16.61)mg/L,PCT(1.89±0.41)μg/L,DD(4.40±0.29)mg/L and BNP(549.91±16.79)pg/ml]in the observation group(P<0.05).After treatment,it was found that 6 cases of children in the observation group died,and 78 cases survived.CRP(151.88±16.75)mg/L,PCT(2.53±0.29)μg/L,DD(4.61±0.66)mg/L and BNP(526.46±31.99)pg/ml in dead children were higher than those[CRP(99.63±15.99)mg/L,PCT(1.35±0.31)μg/L,DD(2.88±0.61)mg/L and BNP(89.41±22.27)pg/ml]in surviving children(P<0.05).The AUC was relatively high,indicating high diagnostic efficacy according to the cut-off value.Conclusion In the diagnosis of children with severe pneumonia,as well as predicting the prognosis,CRP,PCT,DD and BNP index levels have high application value and convenient clinical examination,which can provide early warning information in time and improve the success rate of treatment.