流感病毒与腺病毒所致肺炎患儿EOS、CRP、PCT水平差异及诊断意义

Differences in EOS,CRP and PCT Levels Between Influenza Virus and Adenovirus Induced Pneumonia in Children and Their Diagnostic Significance

目的对比流感病毒与腺病毒所致肺炎患儿嗜酸性粒细胞(EOS)、C反应蛋白(CRP)、降钙素原(PCT)水平差异,并评价其诊断价值。方法选取河南大学淮河医院2022年1月至2023年8月52例流感病毒患儿作为流感病毒组,52例腺病毒感染患儿作为腺病毒组,另选取同期52例健康体检患儿作为正常组。比较3组EOS、CRP、PCT水平,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价EOS、CRP、PCT对流感病毒与腺病毒所致肺炎的诊断价值。结果腺病毒组的EOS、CRP、PCT水平均高于流感病毒组和正常组,流感病毒组上述各项指标高于正常组(P<0.05);流感病毒、腺病毒肺炎患儿的EOS、CRP、PCT水平高于单纯病毒感染无肺炎患儿,而腺病毒肺炎患儿的上述各项指标水平高于流感病毒组肺炎患儿(P<0.05);EOS、CRP、PCT诊断腺病毒与流感病毒感染的AUC分别为0.803、0.727、0.763,诊断腺病毒所致肺炎与单纯腺病毒感染的AUC分别为0.815、0.803、0.784,诊断流感病毒所致肺炎与单纯流感病毒感染的AUC分别为0.806、0.817、0.774,诊断腺病毒与流感病毒所致肺炎的AUC分别为0.825、0.787、0.749。EOS、CRP、PCT高表达提示腺病毒感染所致肺炎的风险是流感病毒所致肺炎的2.897、4.125、4.307倍。结论与流感病毒所致肺炎患儿相比,腺病毒所致肺炎患儿EOS、CRP、PCT水平明显较高,三者均具有良好的鉴别诊断价值。

Objective To compare the levels of eosinophils(EOS),C-reactive protein(CRP)and procalcitonin(PCT)in children with pneumonia caused by influenza virus and adenovirus,and to evaluate their diagnostic value.Methods A total of 52 children with influenza virus in Huaihe Hospital of Henan University from January 2022 to August 2023 were selected as influenza virus group,52 children with adenovirus infection were selected as adenovirus group,and 52 healthy children with physical examination during the same period were selected as normal group.The levels of EOS,CRP and PCT in the three groups were compared,and the diagnostic value of EOS,CRP and PCT in influenza virus and adenovirus induced pneumonia was evaluated by receiver operating characteristic(ROC)curve and area under the curve(AUC).Results The levels of EOS,CRP and PCT in adenovirus group were higher than influenza virus group and the normal group,and the above indexes in influenza virus group were higher than those in normal group(P<0.05).The levels of EOS,CRP and PCT in children with adenovirus pneumonia and influenza virus pneumonia were higher than those in children with simple virus infection without pneumonia,and the above indexes in the children with adenovirus pneumonia were higher than those in the influenza virus group(P<0.05).The AUC of EOS,CRP and PCT for the diagnosis of adenovirus and influenza virus infection were 0.803,0.727 and 0.763,respectively.The AUC for the diagnosis of adenovirus-induced pneumonia and simple adenovirus infection were 0.815,0.803 and 0.784,respectively.The AUC for diagnosing pneumonia caused by influenza virus and influenza virus infection alone were 0.806,0.817 and 0.774,respectively.The AUC for diagnosing pneumonia caused by adenovirus and influenza virus was 0.825,0.787 and 0.749,respectively.The high expression of EOS,CRP and PCT suggested that the risk of pneumonia caused by adenovirus infection was 2.897,4.125 and 4.307 times that of pneumonia caused by influenza virus.Conclusion The levels of EOS,CRP and PCT in children with pneumonia caused by adenovirus are significantly higher than those of children with pneumonia caused by influenza virus,and all three have good value in differential diagnosis.