本研究旨在探讨血清降钙素原(PCT)的表达及意义。白三烯B4(LTB4),血清淀粉样蛋白A(SAA),C反应蛋白(CRP)在不同类型肺炎患儿引起不同病原感染中的作用。纳入2019年7月至2020年6月珠海市第五人民医院收治的百一株肺炎患儿,分为细菌组38例,支原体组30例,根据病原体的不同类型,病毒组33例。将患者分为非危重组42例,危重组33例,根据儿科临床疾病评分(PCIS),非常危重组26例,选取同期健康儿童30例作为对照组。血清PCT比较,SAA:细菌组>支原体组>病毒组>对照组,差异有统计学意义(P<0.05)。受试者工作特征(ROC)分析显示,血清PCT曲线下面积(AUC),LTB4、SAA、诊断细菌性肺炎的CRP分别为1.000,0.531,0.969,0.833,和诊断支原体肺炎的AUC分别为0.653、0.609、0.547和0.652,诊断病毒性肺炎的AUC分别为0.888、0.570、0.955和1.000。血清PCT比较,LTB4、SAA:非常关键组>关键组>非关键组>对照组,差异有统计学意义(P<0.05)。血清PCT,经Pearson分析,LTB4、SAA与PCIS评分呈负相关(P<0.05)。血清PCT和SAA对细菌性肺炎的诊断价值,血清SAA和CRP对病毒性肺炎有诊断价值;血清PCT,LTB4和SAA与疾病的严重程度相关,并且随着病情的恶化显示更高的表达。
This study aimed to investigate the expression and significance of serum procalcitonin (PCT), leukotriene B4 (LTB4), Serum amyloid A (SAA), and C-reactive protein (CRP) in children with different types of pneumonia caused by different pathogenic infections. One hundred and one children with pneumonia admitted to The Fifth People Hospital of Zhuhai from July 2019 to June 2020 were enrolled and divided into 38 cases in the bacterial group, 30 cases in the mycoplasma group, and 33 cases in the virus group according to the different types of pathogens. The patients were divided into 42 cases in the noncritical group, 33 cases in the critical group, and 26 cases in the very critical group according to the pediatric clinical illness score (PCIS), and 30 healthy children were selected as the control group during the same period. Comparison of serum PCT, SAA: bacterial group > mycoplasma group > viral group > control group with significant differences (P < .05). Receiver operator characteristic (ROC) analysis showed that the area under the curves (AUCs) of serum PCT, LTB4, SAA, and CRP for the diagnosis of bacterial pneumonia were 1.000, 0.531, 0.969, and 0.833, respectively, and the AUCs for the diagnosis of mycoplasma pneumonia were 0.653, 0.609, 0.547, and 0.652, respectively, and the AUCs for the diagnosis of viral pneumonia were 0.888, 0.570, 0.955, and 1.000, respectively. Comparison of serum PCT, LTB4, SAA: very critical group > critical group > noncritical group > control group, with significant differences (P < .05). Serum PCT, LTB4, and SAA were negatively correlated with PCIS score by Pearson analysis (P < .05). Serum PCT and SAA showed diagnostic value for bacterial pneumonia, and serum SAA and CRP showed diagnostic value for viral pneumonia; serum PCT, LTB4, and SAA correlate with severity of disease and show higher expression with worsening of the condition.