小儿支气管肺炎患儿WBC与心肌酶谱变化及其疗效的关系

The relationship between WBC and myocardial enzymes changes in children with bronchopneumonia and the efficacy

目的 探讨小儿支气管肺炎患儿白细胞计数(WBC)与心肌酶谱变化及其疗效的关系。方法 选取我院2021年1月至2022年12月收治的80例小儿支气管肺炎患儿为研究对象,根据入院时患儿临床症状严重程度分为重症组(32例)和轻症组(48例),根据治疗7 d后的疗效将患儿分为疗效良好(59例)和疗效不良(21例)2个亚组。比较2组(入院时)及不同预后患儿(入院时、治疗3 d、7 d后)白细胞计数(WBC)、血清天门冬氨酸氨基转移酶(AST)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBDH)水平,分析入院时WBC、AST、CK-MB、α-HBDH水平与小儿支气管肺炎病情严重程度的相关性,偏回归分析小儿支气管肺炎疗效不良的危险因素,受试者工作特征曲线(ROC)分析治疗3 d后WBC、AST、CK-MB、α-HBDH水平联合预测小儿支气管肺炎疗效不良的价值。结果 入院时重症组WBC、AST、CK-MB、α-HBDH水平高于轻症组(P<0.05);相关性分析结果显示,入院时WBC、AST、CK-MB、α-HBDH水平与病情严重程度均呈正相关(P<0.05);治疗3 d、7 d后疗效不良患儿WBC、AST、CK-MB、α-HBDH水平均高于疗效良好患儿(P<0.05);偏回归分析显示,治疗3 d后WBC(>10.61×10^(9)/L)、AST(>50.66 U/L)、CK-MB(>27.99 U/L)、α-HBDH(>212.48 U/L)水平是小儿支气管肺炎患儿疗效不佳的危险因素(P<0.05);ROC分析结果显示,治疗3 d后WBC、AST、CK-MB、α-HBDH水平联合预测小儿支气管肺炎疗效不佳的AUC为0.851,最佳预测敏感度、特异度分别为90.53%、75.62%。结论 小儿支气管肺炎患儿WBC、AST、CK-MB、α-HBDH表达水平与病情程度呈正相关,且治疗3 d后各指标联合在预测疗效不良方面具有较高预测效能。

Objective To explore the relationship between white blood cell count(WBC)and changes in myocardial enzyme spectrum in children with bronchopneumonia and their therapeutic effects.Methods A total of 80 children with bronchopneumonia admitted to our hospital from January 2021 to December 2022 were selected as research objects.According to the severity of clinical symptoms at admission,the children were divided into a severe group(32 cases)and a mild group(48 cases),and were divided into two subgroups:59 cases with good efficacy and 21 cases with poor efficacy according to the efficacy after 7 days of treatment.The levels of white blood cell count(WBC),serum aspartate aminotransferase(AST),creatine kinase isoenzyme(CK-MB)andα-hydroxybutyrate dehydrogenase(α-HBDH)were compared between the 2 groups(on admission)and the children with different prognosis(on admission,3 and 7 days after treatment).The correlation between the level of WBC,AST,CK-MB andα-HBDH at admission and the severity of bronchopneumonia in children was analyzed,and partial regression analysis was used to analyze the risk factors for poor efficacy in pediatric bronchopneumonia.The value of combining WBC,AST,CK-MB,andα-HBDH levels after 3 days of treatment was analyzed using the receiver operating characteristic curve(ROC)to predict poor efficacy in pediatric bronchopneumonia.The ROC analysis results showed that the AUC of the combination of WBC,AST,CK-MB,andα-HBDH levels predicting poor efficacy in pediatric bronchopneumonia after 3 days of treatment was 0.851,the best predictive sensitivity and specificity were 90.53% and 75.62%,respectively.Results The levels of WBC,AST,CK-MB andα-HBDH in severe group were higher than those in mild group(P<O.05);correlation analysis showed that WBC,AST,CK-MB andα-HBDH levels were positively correlated with the severity of the disease at admission(P<0.05);after 3 and 7 days of treatment,the WBC,AST,CKMB,andα-HBDH levels in children with poor efficacy were on average higher than those in children with good efficacy(P<0.05);partial regression analysis showed that WBC(>10.61×10^(9)/L),AST(>50.66 U/L),CK-MB(>27.99 U/L),and α-HBDH(>212.48 U/L)levels after 3 days of treatment were risk factors for poor efficacy in pediatric bronchopneumonia(P<0.05);the ROC analysis results showed that the AUC of poor efficacy predicted by the combination of WBC,AST,CKMB,andα-HBDH levels after 3 days of treatment in pediatric bronchopneumonia was O.851,and the best predictive sensitivity and specificity were 90.53% and 75.62%,respectively.Conclusion The expression levels of WBC,AST,CK-MB,andα-HBDH in children with bronchopneumonia are positively correlated with the severity of the disease,and the combination of various indicators after 3 days of treatment has high predictive power in predicting poor efficacy.