CRP与IL-6联合检测对儿童重症肺炎支原体肺炎的预测价值研究

The predictive value of combined detection of C-reactive protein and IL-6 in children with severe Mycoplasma pneumoniae pneumonia

目的本次研究旨在调查CRP与IL-6联合检测对儿童重症支原体肺炎(SMPP)的早期预测价值。方法本院2019年3月—2022年6月诊断为肺炎支原体肺炎(MPP)的住院患儿纳入研究对象,并分为重症肺炎组(SMPP)和普通肺炎组(GMPP)。分析比较2组患儿的一般情况、超敏C-反应蛋白(CRP)和白介素-6(IL-6)。通过绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析SMPP患儿CRP和IL-6的临界值(cut-off),并且通过二元logistic回归分析评价两者联合检测对SMPP的预测价值。结果本次研究共纳入222例MPP患儿,其中SMPP组39例,GMPP组183例。2组患儿性别、年龄均无统计学意义,SMPP组患儿的住院时间较GMPP长,差异有统计学意义(P=0.00)。SMPP组的CRP和IL-6水平明显高于GMPP组,差异有统计学意义(P<0.05)。ROC曲线分析中,CRP和IL-6的最佳临界值分别为12.80 mg/L和41.43 pg/ml时,区分SMPP和GMPP的敏感度和特异度分别为66.7%和60.1%及61.5和68.3%,ROC的曲线下面积(area under curve,AUC)值分别为0.652和0.689,CRP与IL-6联合诊断的AUC值为0.711。结论CRP和IL-6可作为SMPP重要的预测指标,CRP和IL-6联合检测对SMPP的预测价值最高。

Objective This study aimes to investigate the early predictive value of combined detection of C-reactive protein(CRP)and interleukin-6(IL-6)in children with severe Mycoplasma pneumoniae pneumonia(SMPP).Methods Children diagnosed with Mycoplasma pneumoniae pneumonia(MPP)in our hospital from March 2019 to June 2022 were investigated in the study.And they were divided into two groups:severe Mycoplasma pneumoniae pneumonia group(SMPP)and general Mycoplasma pneumoniae pneumonia group(GMPP).The clinical condition,CRP and IL-6 between the two groups were analyzed and compared.Receiver operating characteristic(ROC)curves were made to explore the diagnostic values of CRP and IL-6,and the predictive value of combined detection of CRP and IL-6 was evaluated by binary logistic regression analysis.Results A total of 222 children were included into this study,39 children were in the SMPP group,and 183 were in the GMPP group.There was no statistical significance on the differences in age and gender between the two groups.The hospitalization time of the children in the SMPP group was significantly longer than that in the GMPP group,with the differences statistically significant(P=0.00).The levels of CRP and IL-6 in SMPP group were higher than those in GMPP group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that when the optimal cut-off values of CRP and IL-6 were set at 12.80 mg/L and 41.43 pg/ml,respectively,the sensitivity and specificity in differentiating SMPP from GMPP were 66.7% and 60.1%,61.5% and 68.3%,respectively.And the area under the curve(AUC)of CRP and IL-6 was 0.652 and 0.689,respectively.The AUC of combined detection of CRP and IL-6 was 0.711.Conclusion CRP and IL-6 might be the significant predictors for SMPP,and the combined detection of CRP and IL-6 has the optimal predictive value for SMPP.