降钙素原和肺部超声算法在儿童重症肺炎诊断中的应用研究

A Study of Procalcitonin and Lung Ultrasound Algorithms in the Diagnosis of Severe Pneumonia in Children

目的研究降钙素原和肺部超声算法在儿童重症肺炎诊断中的应用价值。方法回顾性分析2020年3月—2022年10月郴州市第一人民医院接收的134例儿童肺炎和100例健康体检儿童的临床资料,健康体检儿童纳入健康组,儿童肺炎根据病情是否为重症肺炎划分为非重症组(n=103)、重症组(n=31)。3组患儿均接受降钙素原和肺部超声检查,对比3组的降钙素原水平、肺部超声评分,分析降钙素原和肺部超声算法在儿童重症肺炎诊断中的效能。结果与健康组对比,非重症组、重症组的降钙素原水平、肺部超声评分明显升高,且重症组的降钙素原水平、肺部超声评分高于非重症,差异有统计学意义(P<0.05);降钙素原联合肺部超声算法在儿童重症肺炎中的诊断敏感性(100.00%)、特异性(99.03%)、准确性(99.25%)均高于降钙素原(77.42%、91.26%、88.06%),差异有统计学意义(χ^(2)=5.143、6.125、11.529,P<0.05)。降钙素原联合肺部超声算法在儿童重症肺炎中的特异性(99.03%)、准确性(99.25%)均高于肺部超声算法(92.23%、90.30%),差异有统计学意义(P<0.05),敏感性(100.00%)与肺部超声算法(83.87%)对比,差异无统计学意义(P>0.05)。结论在儿童重症肺炎诊断中,重症患儿的降钙素原水平、肺部超声评分明显升高,且降钙素原联合肺部超声算法能提高诊断效能。

Objective To study the application value of procalcitonin and lung ultrasound algorithm in the diagnosis of severe pneumonia in children.Methods The clinical data of 134 children with pneumonia and 100 healthy children who received physical examination in Chenzhou First People's Hospital from March 2020 to October 2022 were retrospectively analyzed.Healthy children were included in the healthy group.Children with pneumonia were divided into non-severe group(n=103)and severe group(n=31)according to whether the condition was severe pneumonia.All the three groups received procalcitonin and lung ultrasound examination.The procalcitonin level and lung ultrasound score of the three groups were compared,and the efficacy of procalcitonin and lung ultrasound algorithm in the diagnosis of severe pneumonia in children was analyzed.Results Compared with the healthy group,the procalcitonin level and lung ultrasound score of the non-severe group and the severe group were significantly increased,and the procalcitonin level and lung ultrasound score of the severe group were higher than those of the non-severe group,the differences were statistically significant(P<0.05);the diagnostic sensitivity(100.00%),specificity(99.03%)and accuracy(99.25%)of procalcitonin combined with pulmonary ultrasound algorithm in children with severe pneumonia were higher than those of procalcitonin(77.42%,91.26%,88.06%),and the differences were statistically significant(χ^(2)=5.143,6.125,11.529,P<0.05).The specificity(99.03%)and accuracy(99.25%)of procalcitonin combined with pulmonary ultrasound algorithm in children with severe pneumonia were higher than those of pulmonary ultrasound algorithm(92.23%,90.30%),and the difference was statistically significant(P<0.05).There was no significant difference in sensitivity(100.00%)and pulmonary ultrasound algorithm(83.87%)(P>0.05).Conclusion In the diagnosis of severe pneumonia in children,procalcitonin levels and lung ultrasound scores were significantly higher in severely ill children,and the procalcitonin combined with lung ultrasound algorithm could improve diagnostic efficacy.