降钙素原、白细胞介素-6、血清淀粉样蛋白A、C反应蛋白及白细胞计数水平对儿童肺炎并发脓毒血症的预测价值

Predictive value of procalcitonin, interleukin-6, serum amyloid A, C-reactive protein and white blood cells levels in children with pneumonia complicated with sepsis

目的探讨降钙素原(PCT)、白细胞介素-6(IL-6)、血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)及白细胞计数(WBC)水平对儿童肺炎并发脓毒血症的预测价值。方法随机选取2021年1月至2022年4月就诊于蚌埠市第三人民医院儿科的120例肺炎患儿,在患儿办理入院后,根据是否并发脓毒血症,将其分为肺炎组(A组,n=72)与肺炎并发脓毒血症组(B组,n=48)。收集患儿的病史、相关临床资料及入院时的PCT、IL-6、SAA、CRP、WBC与血乳酸,分析所收集的相关数据在两组间有无差异,并采用受试者工作特征(ROC)曲线分析各项指标单独及联合应用的预测效能。结果B组的PCT、IL-6、SAA、CRP、WBC高于A组,差异有统计学意义(P<0.05)。回归分析结果显示,肺炎并发脓毒血症危险因素包括PCT、IL-6、SAA、CRP、WBC(P<0.05)。ROC曲线显示,单独使用PCT、IL-6、SAA、CRP、WBC检测或者使用联合检测方式,均能够在该疾病判断中起到预测作用,其中PCT、IL-6、SAA、CRP联合预测的价值最高。结论对于肺炎患儿,PCT、IL-6、SAA、CRP、WBC均为合并脓毒血症的独立预测因子,而PCT、IL-6、SAA、CRP的联合检测能够进一步提升预测的准确性。

Objective To investigate the predictive value of procalcitonin(PCT),interleukin-6(IL-6),serum amyloid A(SAA),C-reactive protein(CRP)and white blood cells(WBC)in children with pneumonia complicated with sepsis.Methods A total of 120 children with pneumonia who were admitted to the Department of Pediatrics of the Third People’s Hospital of Bengbu from January 2021 to April 2022 were randomly selected.After admission,they were divided into pneumonia group(group A,n=72)and pneumonia complicated with sepsis group(group B,n=48)according to whether they were complicated with sepsis.The medical history,related clinical data,PCT,IL-6,SAA,CRP,WBC and serum lactate at admission were collected.The differences of the collected data between the two groups were analyzed.The receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of each index alone and in combination.Results PCT,IL-6,SAA,CRP and WBC in group B were higher than those in group A,the differences were statistically significant(P<0.05).The results of regression analysis showed that the risk factors of pneumonia complicated with sepsis included PCT,IL-6,SAA,CRP,WBC(P<0.05).ROC curve showed that PCT,IL-6,SAA,CRP,WBC alone or combined detection could play a predictive role in the diagnosis of the disease,and PCT,IL-6,SAA,CRP combined prediction value was the highest.Conclusion PCT,IL-6,SAA,CRP and WBC are independent predictors of sepsis in children with pneumonia,and the combined detection of the above four indicators can further improve the accuracy of prediction.