IL-6、PCT、IgG儿童激素敏感型PNS细菌感染性肺炎易感性及复发的评估价值

Evaluation value of IL-6,PCT,IgG in children with hormone-sensitive PNS bacteria infection pneumonia susceptibility and recurrence

目的探讨白细胞介素-6(IL-6)、降钙素原(PCT)、免疫球蛋白G(IgG)对儿童激素敏感型原发性肾病综合征(PNS)细菌感染性肺炎易感性及复发的评估价值。方法选取2019年1月至2023年3月该院收治的150例儿童激素敏感型PNS患儿作为研究对象。根据随访3个月内是否并发细菌感染性肺炎分为并发组、未并发组,比较两组基线IL-6、PCT、IgG水平,采用Logistic回归分析影响细菌感染性肺炎易感性的因素,绘制受试者工作特征(ROC)曲线分析IL-6、PCT、IgG评估PNS细菌感染性肺炎易感性的价值及PNS复发风险。结果并发组IL-6[(7.84±2.49)pg/mL]、PCT[(0.39±0.11)ng/mL]高于未并发组[(4.75±1.56)pg/mL、(0.29±0.09)ng/mL],IgG[(3.82±1.25)g/L]低于未并发组[(5.92±1.97)g/L],差异均有统计学意义(P<0.05);细菌感染性肺炎易感性的Logistic回归方程显示,随着IL-6、PCT升高及IgG降低,细菌感染性肺炎易感性逐渐升高,差异有统计学意义(P<0.05);IL-6、PCT、IgG评估PNS细菌感染性肺炎易感性的AUC依次为0.792、0.744、0.677,IL-6、PCT联合IgG评估PNS细菌感染性肺炎易感性的AUC为0.929,大于IL-6、PCT、IgG单独评估(P<0.05);IL-6高水平患者PNS复发的风险是低水平的7.054倍,PCT高水平患者PNS复发的风险是低水平的6.750倍,IgG高水平患者PNS复发的风险是低水平的0.079倍,差异有统计学意义(P<0.05)。结论IL-6、PCT、IgG是儿童激素敏感型PNS细菌感染性肺炎的影响因素,三者与PNS复发有关,临床可根据IL-6、PCT、IgG水平评估患儿并发细菌性肺炎易感性及病情复发风险,从而为预防性临床干预提供指导。

Objective To investigate the value of interleukin-6(IL-6),procalcitonin(PCT)and immunoglobulin G(IgG)in evaluating the susceptibility and recurrence of bacterial pneumonia in children with hormone-sensitive primary nephrotic syndrome(PNS).Methods A total of 150 children with hormone-sensitive PNS admitted to the hospital from January 2019 to March 2023 were selected as the study objects.The patients were divided into concurrent group and non-concurrent group according to whether bacterial pneumonia was complicated or not within 3 months.The baseline IL-6,PCT and IgG levels of the two groups were compared,and the factors affecting susceptibility to bacterial pneumonia were analyzed by Logistic regression.Receiver operating characteristic curve(ROC)was drawn to analyze the value of IL-6,PCT and IgG in assessing susceptibility to PNS bacterial pneumonia and the risk of PNS recurrence.Results IL-6[(7.84±2.49)pg/mL]and PCT[(0.39±0.11)ng/mL]in concurrent group were higher than those in non-concurrent group[(4.75±1.56)pg/mL,(0.29±0.09)ng/mL].IgG[(3.82±1.25)g/L]was lower than that of non-concurrent group[(5.92±1.97)g/L],and the differences were statistically significant(P<0.05).Logistic regression equation showed that with the increase of IL-6 and PCT and the decrease of IgG,the susceptibility to bacterial pneumonia gradually increased,and the difference was statistically significant(P<0.05).The AUC of IL-6,PCT and IgG for PNS bacterial pneumonia susceptibility was 0.792,0.744 and 0.677,respectively.The AUC of IL-6 and PCT combined IgG for PNS bacterial pneumonia susceptibility was 0.929,which was higher than that of IL-6,PCT and IgG alone(P<0.05).The risk of PNS recurrence in patients with high IL-6 level was 7.054 times that of low IL-6 level,the risk of PNS recurrence in patients with high PCT level was 6.750 times that of low PCT level,and the risk of PNS recurrence in patients with high IgG level was 0.079 times that of low level,the differences were statistically significant(P<0.05).Conclusion IL-6,PCT and IgG are the influencing factors of hormone-sensitive PNS bacterial pneumonia in children,and they are related to the recurrence of PNS.Clinically,IL-6,PCT and IgG levels can be used to evaluate the susceptibility and recurrence risk of bacterial pneumonia in children,so as to provide guidance for preventive clinical intervention.