大叶性肺炎患儿血清及肺泡灌洗液hs-CRP、PCT水平与病情严重程度的相关性

Correlation between levels of hs-CRP and PCT in serum and alveolar fluid and disease severity in children with lobar pneumonia

目的 探究大叶性肺炎患儿血清及肺泡灌洗液中超敏C反应蛋白(hs-CRP)、降钙素原(PCT)水平与病情严重程度的相关性。方法 以2020年9月—2021年9月112例大叶性肺炎患儿为研究对象,采集患者儿血清和肺泡灌洗液,采用双抗体夹心ELISA法检测患儿血清和肺泡灌洗液hs-CRP、PCT水平。采用肺部感染评分(clinical pulmonary infection score,CPIS),将患儿分为重症组(CPIS≥6分)和轻症组(CPIS<6分),根据患儿治疗情况分为预后较好组(治愈、好转)及预后不良组(未愈),分析血清和肺泡灌洗液hs-CRP、PCT水平与患儿病情严重程度的相关性及对其预后预测价值。结果 重症组和轻症组患儿血清hs-CRP、PCT分别为(17.73±3.26)μg/L和(12.58±3.09)μg/L、(8.59±1.84)μg/L和(5.62±1.59)μg/L,肺泡灌洗液hs-CRP、PCT分别为(21.25±4.18)μg/L和(13.79±2.76)μg/L、(8.71±1.54)μg/L和(5.38±1.69)μg/L,重症组明显高于轻症组,差异均有统计学意义(P<0.05),患儿血清和肺泡灌洗液中hs-CRP、PCT水平与CPIS评分呈正相关(r=0.398、0.441;0.475、0.586,P<0.05);预后不良组和预后较好组血清hs-CRP、PCT分别为(20.09±4.20)μg/L和(13.35±2.91)μg/L、(8.75±2.19)μg/L和(6.28±1.31)μg/L,肺泡灌洗液中hs-CRP、PCT分别为(23.70±4.29)μg/L和(15.08±3.56)μg/L、(10.73±2.04)μg/L和(5.79±1.10)μg/L,差异均有统计学意义(P<0.05);血清指标联合检测与肺泡灌洗液指标联合检测预测大叶性肺炎患儿预后的AUC对比无明显差异(P>0.05)。结论 大叶性肺炎患儿血清及肺泡灌洗液hs-CRP、PCT水平显著升高,均与病情严重程度呈正相关,且血清指标联合检测与肺泡灌洗液指标联合检测对大叶性肺炎患儿预后的预测价值相当。

Objective To explore the correlation between levels of hypersensitive C-reactive protein(hs-CRP)and procalcitonin(PCT)in serum and alveolar fluid and severity of disease in children with lobar pneumonia.Methods A total of 112 children diagnosed with lobar pneumonia from September 2020 to September 2021 were selected as the research subjects.The levels of hs-CRP and PCT in serum and alveolar fluid were detected by double antibody sandwich enzyme-linked immunosorbent assay(ELISA).The children were divided into severe group(clinical pulmonary infection score,CPIS≥6 points)and mild group(CPIS<6 points)according to the severity of disease,and further classified into good prognosis group(cured,improved)and poor prognosis group(uncured)according to their treatment outcomes.The correlation of levels of hs-CRP and PCT in serum and alveolar fluid with disease severity in children and their predictive value on prognosis were analyzed.Results The levels of serum hs-CRP and PCT in severe group were(17.73±3.26)µg/L and(8.59±1.84)µg/L,which were significantly higher than corresponding(12.58±3.09)µg/L,and(5.62±1.59)µg/L in mild group(P<0.05);the levels of hs-CRP and PCT in alveolar fluid in severe group were(21.25±4.18)µg/L and(8.71±1.54)µg/L,which were significantly higher than corresponding(13.79±2.76)µg/L and(5.38±1.69)µg/L in mild group(P<0.05).The levels of hs-CRP and PCT in serum and alveolar fluid were positively correlated with CPIS scores(r=0.398,0.441;0.475,0.586,P<0.05).The levels of hs-CRP and PCT in serum in poor prognosis group were(20.09±4.20)µg/L and(13.35±2.91)µg/L,which were significantly higher corresponding(8.75±2.19)µg/L and(6.28±1.31)µg/L in good prognosis group(P<0.05).The levels of hs-CRP and PCT in alveolar fluid were(23.70±4.29)µg/L and(10.73±2.04)µg/L,which were higher than corresponding(15.08±3.56)µg/L and(5.79±1.10)µg/L in poor prognosis group(P<0.05).There was no significant difference in AUC between combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators in predicting the prognosis of children with lobar pneumonia(P>0.05).Conclusions The levels of hs-CRP and PCT in serum and alveolar fluid of children with lobar pneumonia are significantly increased and positively correlated with the severity of disease.However,the predictive value of the combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators for the prognosis of children with lobar pneumonia is comparable.