摘要
目的探讨血清1,25二羟维生素D_(3)[1,25(OH)_(2)D_(3)]联合超敏C反应蛋白(hs-CRP)水平对支气管肺炎患儿合并脓毒症的诊断效能。方法选择101例支气管肺炎合并脓毒症患儿作为病例组,88例单纯支气管肺炎患儿作为对照组。检测两组患儿血清1,25(OH)_(2)D_(3)、hs-CRP、降钙素原、白细胞介素6(IL-6)水平及血清淀粉样蛋白A(SAA)水平,并对两组患儿进行小儿危重病例评分(PCIS)。分析各指标与PCIS的相关性,应用受试者工作特征(ROC)曲线评价血清1,25(OH)_(2)D_(3)、hs-CRP、降钙素原、IL-6、SAA水平及血清1,25(OH)_(2)D_(3)联合hs-CRP水平对支气管肺炎患儿合并脓毒症的诊断效能。结果病例组的血清1,25(OH)_(2)D_(3)水平和PCIS均低于对照组,血清hs-CRP、降钙素原、IL-6、SAA水平均高于对照组(均P<0.05)。相关分析结果显示,血清1,25(OH)_(2)D_(3)水平与PCIS呈正相关,血清hs-CRP、降钙素原、IL-6、SAA水平与PCIS均呈负相关(均P<0.05)。血清1,25(OH)_(2)D_(3)、hs-CRP、降钙素原、IL-6、SAA水平及血清1,25(OH)_(2)D_(3)联合hs-CRP水平诊断支气管肺炎患儿合并脓毒症的ROC曲线下面积分别为0.854、0.777、0.855、0.643、0.699、0.900,血清1,25(OH)_(2)D_(3)联合hs-CRP水平诊断支气管肺炎合并脓毒症的ROC曲线下面积均大于各指标单独诊断(均P<0.05)。结论在支气管肺炎患儿中,血清1,25(OH)_(2)D_(3)水平联合hs-CRP水平对其合并脓毒症具有较高的诊断价值,值得临床推广应用。
Objective To investigate the diagnostic efficiency of serum 1,25-dihydroxyvitamin D_(3)(1,25(OH)_(2)D_(3))combined with high-sensitivity C-reactive protein(hs-CRP)levels on complication of sepsis in children with bronchopneumonia.Methods A total of 101 bronchopneumonia children complicated with sepsis were selected as the case group,and 88 children with bronchopneumonia alone were selected as the control group.The levels of serum 1,25(OH)_(2)D_(3),hs-CRP,procalcitonin,interleukin 6(IL-6)and serum amyloid A(SAA)were detected in both groups;furthermore,the Pediatric Critical Illness Score(PCIS)was performed in the two groups.The correlation of various indices with PCIS was analyzed.The receiver operating characteristic(ROC)curve was performed to evaluate the diagnostic efficiency of serum 1,25(OH)_(2)D_(3),hs-CRP,procalcitonin,IL-6 and SAA levels,as well as serum 1,25(OH)_(2)D_(3) combined with hs-CRP levels on complication of sepsis in children with bronchopneumonia.Results The serum 1,25(OH)_(2)D_(3) level and PCIS in the case group were lower than those in the control group,and the levels of serum hs-CRP,procalcitonin,IL-6 and SAA were higher in the case group than in the control group(all P<0.05).The results of related analysis revealed that serum 1,25(OH)_(2)D_(3) level positively correlated with PCIS,while serum hs-CRP,procalcitonin,IL-6,SAA levels negatively correlated with PCIS(all P<0.05).The areas under the ROC curve of the levels of serum 1,25(OH)_(2)D_(3),hs-CRP,procalcitonin,IL-6 and SAA,as well as serum 1,25(OH)_(2)D_(3) combined with hs-CRP levels for diagnosing complication of sepsis in children with brochopneumonia were 0.854,0.777,0.855,0.643,0.699,and 0.900 respectively,and the areas under the ROC curve of serum 1,25(OH)_(2)D_(3) combined with hs-CRP levels for diagnosing brochopneumonia complicated with sepsis were larger than that of single diagnosis of various indices(all P<0.05).Conclusion In the children with brochopneumonia,serum 1,25(OH)_(2)D_(3) level combined with hs-CRP level exerts a high diagnostic value on concomitant sepsis,which is worthy of promotion and application in clinics.
作者
樊省廉
周莉
何勤
FAN Sheng-lian;ZHOU Li;HE Qin(Department of Pediatrics,Guilin People′s Hospital,Guilin 541000,Guangxi,China)
出处
《广西医学》
CAS
2022年第16期1827-1830,1854,共5页
Guangxi Medical Journal
基金
广西桂林市科学研究与技术开发计划(20170109-2)。
关键词
支气管肺炎
脓毒症
1
25二羟维生素D
3
超敏C反应蛋白
诊断效能
Bronchopneumonia
Sepsis
1
25-dihydroxyvitamin D 3
High-sensitivity C-reactive protein
Diagnostic efficiency
作者简介
樊省廉(1971~),女,本科,副主任医师,研究方向:小儿危重症;通信作者:何勤(1971~),女,硕士,主任医师,研究方向:小儿危重症。
