Clinical Significance Of Serum Inflammatory Factor IL-6 And PCT In Children With Community-acquired Pneumonia

Objective:1 Study on Epidemiological characteristics of onset Age,gender and seasonal Distribution of CAP in Children in our area;2 Study on Community acquired pneumonia in Children,and analysis of the clinical significance of peripheral blood WBC,NEUT,CRP,PCT,IL-6 in the diagnosis of children's CAP;3 To investigate the correlation between the level of serum inflammatory marker CRP,IL-6,PCT and the severity of pneumonia;4 To explore the use of antibiotics and the time of stopping antibiotics in the treatment of children with CAP,and to avoid the abuse of antibiotics,to provide important reference for clinicians in the diagnosis and treatment of pediatric CAP and to obtain a good prognosis.Method:Children with pneumonia hospitalized in pediatrics from January 1st2017 to December 31 st 2017.There were 204 children in the experimental group(pneumonia group),104 males and 100 females.The pneumonia group was divided into mild group and severe group.There were 138 cases(76 males and 62 females)in mild group;66 cases(28 males and 38females)in severe group;70 cases(35 males and 35 females)in normal control group.Blood routine,CRP,PCT,IL-6 and so on were performed within 24 hours of admission to pneumonia group,and blood test was detected in normal control group during physical examination.The serumlevels of IL-6 and PCT were measured by electroche-miluminescence(Cobas E 601)in all children.The names,gender,age,onset season,body temperature,mental state,respiratory frequency,complications,cure rate and case fatality rate were recorded in detail and statistics of all children's serum WBC,NEUT,CRP,PCT and Interleukin-6 values.Analysis by SPSS23.0 statistical software.Results:1 In the pneumonia group,143 children under the age of 5 years old accounted for 70% in the experimental group and 61 children > 5 years old,accounting for 30% in the experimental group.The incidence of pneumonia in children under 5 years old is high and the difference is statistically significant(P<0.05).According to seasonal statistics,there were 50 cases in spring,13 cases in summer,38 cases in autumn and 103 cases in winter.2 Before effective treatment,the serum levels of CRP,PCT,IL-6 in mild patients were significantly higher than those in normal controls(P<0.05).There was no significant difference in the level of serum WBC,NEUT between the mild group and the normal control group(P>0.05).The serum level of CRP,PCT,IL-6 in severe group was significantly higher than that in normal control group,and the difference was statistically significant(P<0.05).There was no significant difference in the level of serum WBC,NEUT between the severe group and the normal control group(P>0.05).3 There was a positive correlation between serum PCT level and traditional inflammatory index WBC,NEUT and CRP(P<0.05),and a positive correlation between serum IL-6 level and traditional inflammatory index WBC,NEUT and CRP(P<0.05).4 Analysis of ROC Curve in the diagnosis of CAP in Children: The area under the ROC curve of single index of serum WBC,CRP,PCT,and IL-6 in the diagnosis of pediatric CAP is 0.639,0.640,0.943 and 0.800,respectively.Area of PCT Maximum.At the critical value of 8.69 mg·L-10.04 ng·ml-1 and 4.60 pg·ml-1,respectively,for the CRP/PCT,IL-6,the results of ROC curve analysis showed that the diagnostic sensitivity,specificity and Yorden index of CRP for detecting CAP were 0.441,0.04 and 0.427,respectively.The diagnostic sensitivity,specificity and Yorden index of PCT for detecting CAP were 0.896,0.917 and 0.813,respectively.The diagnostic sensitivity,specificity and Yorden index of IL-6 for detecting CAP were 0.817,0.750 and 0.567,respectively.The area under the ROC curve of CAP diagnosed by PCT and IL-6 was 0.952,and the sensitivity,specificity and Yorden index of ROC curve were 0.980,0.687 and 0.668 respectively.Conclusion: The incidence of pneumonia in children under 5 years of age in this area is high,and the incidence of pneumonia is more frequent in winter and spring.It is important to diagnose CAP in children by the inflammatory index CRP,PCT,and IL-6,and its level can be used to judge the severity of inflammation.The higher the level,the more severe the pneumonia.However,since there is no highest sensitivity and specificity for a single indicator,joint detection is required for diagnosis.