炎症指标联合检测对支气管肺炎的诊断价值

Diagnostic value of combined detection of inflammatory markers for bronchopneumonia

目的探讨炎症指标联合检测在支气管肺炎患者诊断及病情评估中的临床价值。方法选择2023年3月—2024年3月在新沂市中医医院就诊的80例支气管肺炎患者作为研究对象,纳入支气管肺炎组,根据病情严重程度将患者分为轻度组(69例)和重度组(11例);另外选择同期80例健康体检者作为对照组。采用化学发光法检测降钙素原(PCT)、白细胞介素-6(IL-6)水平,采用免疫比浊法检测超敏C-反应蛋白(hs-CRP)水平;比较支气管肺炎组和对照组以及不同病情严重程度支气管肺炎患者上述指标水平差异。计算敏感度、特异度、准确度、阴性预测值及阳性预测值分析各指标对支气管肺炎的诊断效能以及与病情严重程度的关系。结果支气管肺炎组的PCT、hs-CRP及IL-6水平均显著高于对照组〔PCT(μg/L):0.25±0.18比0.03±0.02;hs-CRP(mg/L):33.59±8.57比4.16±2.83;IL-6(ng/L):73.03±12.06比2.97±0.47;均P<0.05〕。重度支气管肺炎患者的PCT、hs-CRP及IL-6水平均显著高于轻度组〔PCT(μg/L):0.27±0.15比0.11±0.09;hs-CRP(mg/L):35.03±29.88比15.53±13.01;IL-6(ng/L):75.82±13.06比39.77±4.69;均P<0.05〕。PCT、hs-CRP及IL-6联合检测的敏感度、特异度、准确度、阴性预测值及阳性预测值分别为92.18%、88.02%、97.29%、84.39%、94.11%,均显著高于单一指标检测(PCT分别为90.71%、56.08%、83.04%、69.39%、84.97%;hs-CRP分别为89.92%、59.83%、77.98%、76.85%、86.22%;IL-6分别为91.05%、55.71%、86.92%、62.93%、83.59%;均P<0.05)。结论支气管肺炎患者联合检测PCT、hs-CRP及IL-6可为疾病诊断提供可靠依据,并且与病情严重程度相关。

Objective To investigate the clinical significance of combined detection of inflammatory markers in the diagnosis and disease assessment of patients with bronchopneumonia.Methods A total of 80 patients suffering from bronchopneumonia and treated in Xinyi Hospital of Traditional Chinese Medicine from March 2023 to March 2024 were chosen and incorporated into the bronchopneumonia group.The patients were divided into mild group(69 cases)and severe group(11 cases)according to the severity of symptoms.In addition,80 healthy patients during the same period were selected as control group.The levels of procalcitonin(PCT)and interleukin-6(IL-6)were detected by chemiluminescence assay,and the level of hypersensitive C-reactive protein(hs-CRP)was detected by immunoturbidimetric method.The diagnostic efficacy of each index on bronchopneumonia and its relationship with the severity of disease were analyzed by calculating the sensitivity,specificity,accuracy,negative predictive value and positive predictive value.Results The levels of PCT,hs-CRP and IL-6 in bronchopneumonia group were significantly higher than those in control group[PCT(μg/L):0.25±0.18 vs.0.03±0.02;hs-CRP(mg/L):33.59±8.57 vs.4.16±2.83;IL-6(ng/L):73.03±12.06 vs.2.97±0.47;all P<0.05].The levels of PCT,hs-CRP and IL-6 in patients with severe bronchopneumonia were significantly higher than those in mild group[PCT(μg/L):0.27±0.15 vs.0.11±0.09;hs-CRP(mg/L):35.03±29.88 vs.15.53±13.01;IL-6(ng/L):75.82±13.06 vs.39.77±4.69;all P<0.05].The sensitivity,specificity,accuracy,negative predictive value and positive predictive value of PCT,hs-CRP and IL-6 combined detection were 92.18%,88.02%,97.29%,84.39%and 94.11%,respectively,which were significantly higher than those of single index detection(those of PCT were 90.71%,56.08%,83.04%,69.39%and 84.97%,respectively;those of hs-CRP were 89.92%,59.83%,77.98%,76.85%and 86.22%,respectively;those of IL-6 were 91.05%,55.71%,86.92%,62.93%and 83.59%,respectively;all P<0.05).Conclusion Combined detection of PCT,hs-CRP and IL-6 in patients with bronchopneumonia could provide reliable basis for disease diagnosis and is correlated with the severity of disease.