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小儿肺炎急性期血清PCT hs-CRP水平与心肌损害程度的关系 被引量:3

Relationship between Levels of Serum PCT and hs-CRP and Degree of Myocardial Damage in Acute Stage of Pediatric Pneumonia
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摘要 目的:分析小儿肺炎急性期血清PCT、hs-CRP水平与心肌损害程度的关系。方法:分析137例小儿肺炎急性期患儿,其中合并心肌损害的82例患儿分为心肌损害组,未发生心肌损害的55例归为非心肌损害组,依照心肌损害程度分为轻度组33例、中度组28例、重度组21例。分析心肌损害组和非心肌损害组的基线资料、血清心肌损伤标志物[肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)]、血清PCT、hs-CRP水平,对比轻、中、重度组血清PCT、hs-CRP水平变化;采用Pearson相关性分析患儿血清PCT、hs-CRP水平与CK-MB、cTnI的相关性;应用受试者工作特征(ROC)曲线分析血清PCT、hs-CRP水平及两者联合对肺炎急性期患儿发生心肌损害的诊断价值。结果:两组性别、年龄及发病至入院时间对比,差异无统计学意义(P>0.05);心肌损害组的血清CK-MB、cTnI水平均显著高于非心肌损害组(P<0.05);心肌损害组的血清PCT、hs-CRP水平均显著高于非心肌损害组(P<0.05);不同心肌损害程度的三组患儿血清PCT、hs-CRP水平对比,差异有统计学意义,其中轻度组显著低于中、重度组(P<0.05),中度组显著低于重度组(P<0.05);肺炎急性期并发心肌损害患儿的血清PCT、hs-CRP水平与血清CK-MB水平呈正相关(r=0.621、0.778,均P<0.001),与血清cTnI水平呈正相关(r=0.501、0.6668,均P<0.001);logistics回归分析显示,血清PCT及hs-CRP水平与急性期小儿发生心肌损害相关(P<0.05);ROC分析显示,血清PCT、hs-CRP水平及两者联合诊断小儿肺炎急性期发生心肌损害的AUC分别为0.858、0.914和0.955(P均<0.05),敏感度分别为85.37%、90.24%和93.90%,特异度为72.73%、83.64%和70.91%。结论:血清PCT、hs-CRP高表达可能提示肺炎急性期患儿发生心肌损害,可用于临床辅助诊断。 Objective:To analyze the relationship between levels of serum PCT and hs-CRP and the degree of myocardial damage in children with acute stage of pneumonia.Methods:137 children with acute stage of pediatric pneumonia were analyzed.Among them,82 cases with myocardial damage were enrolled in the myocardial damage group and 55 cases without the occurrence of myocardial damage were included in the non-myocardial damage group.According to the degree of myocardial damage,the children were divided into 33 cases in the mild group,28 cases in the moderate group,and 21 cases in the severe group.The baseline data and levels of serum myocardial damage markers[creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)],serum PCT,and hs-CRP were analyzed in the myocardial damage group,and non-myocardial damage group,and the changes in levels of serum PCT and hs-CRP in mild,moderate and severe groups were compared.Pearson correlation analysis was used to analyze the correlation between levels of serum PCT and hs-CRP and CK-MB and cTnI in children.The receiver operating characteristic(ROC)curve was adopted to analyze the diagnostic value of serum PCT,hs-CRP,and the combination of the two in predicting the occurrence of myocardial damage in children with acute stage of pneumonia.Results:There were no statistical differences in gender,age,and time from onset to admission between the two groups(P>0.05).The levels of serum CK-MB and cTnI in the myocardial damage group were significantly higher than those in the non-myocardial damage group(P<0.05).The levels of serum PCT and hs-CRP were significantly higher in the myocardial damage group than those in the non-myocardial damage group(P<0.05).The differences in serum PCT and hs-CRP levels among the three groups of children with different myocardial damage degrees were statistically significant,among which the levels were significantly lower in the mild group than those in the moderate group and severe group(P<0.05)and were significantly lower in the moderate group than those in the severe group(P<0.05).Serum PCT and hs-CRP levels in children with acute stage of pneumonia complicated with myocardial damage were positively correlated with serum CK-MB levels(r=0.621,0.778,all P<0.001),and were positively correlated with serum cTnI level(r=0.501,0.6668,all P<0.001).Logistic regression analysis revealed that serum PCT and hs-CRP levels were correlated with myocardial damage in children at the acute stage(P<0.05).ROC analysis showed that the AUC values of serum PCT,hs-CRP,and their combination were 0.858,0.914,and 0.955 respectively in the diagnosis of occurrence of myocardial damage in children with acute stage of pneumonia(all P<0.05),and the sensitivities were 85.37%,90.24%,and 93.90%and the specificities were 72.73%,83.64%,and 70.91%respectively.Conclusion:The high expressions of serum PCT and hs-CRP may indicate myocardial damage in children with acute stage of pneumonia,and they can be used for clinical auxiliary diagnosis.
作者 孙先琳 刘冬阳 罗兵兵 尹显源 王君霞 SUN Xianlin;LIU Dongyang;LUO Bingbing(The General Hospital of Western Theater Command,Sichuan Chengdu 610000,China)
出处 《河北医学》 CAS 2022年第9期1452-1457,共6页 Hebei Medicine
基金 四川省卫生健康委员会科研课题,(编号:19PJ286)。
关键词 小儿肺炎 血清PCT 血清HS-CRP 心肌损害 Pediatric pneumonia Serum PCT Serum hs-CRP Myocardial damage
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