| ObjectiveInfectious Pneumonia in Children is a common disease in respiratory system children.It is characterized by acute onset,rapid progression and high mortality.Early detection,diagnosis and treatment of infectious pneumonia in children can effectively improve the clinical symptoms,reduce complications and reduce mortality.More and more attention has been paid to the diagnosis of infectious pneumonia in children,the judgment of infection degree,and the monitoring of treatment plan and effect.In this paper,WBC,hs-CRP,PCT,IL-6,SAA in children with infectious pneumonia in different periods of change,to explore the value of these indicators combined detection in the diagnosis of infectious pneumonia in children.Methods1.Subjects: 60 cases of hospitalized children with bacterial pneumonia and 58 cases of hospitalized children with viral pneumonia from January 2019 to January 2020 in Xuzhou Children’s Hospital were included as the study subjects,and 60 cases of healthy children in physical examination during the same period were included as the control group.Blood collection for laboratory examination is required for the diagnosis of the condition of the child,and the informed consent of the child’s parents before blood drawing,considered by the ethics committee of the Xuzhou Children’s Hospital,it is in line with medical ethics.2.Samples: 2m L of blood samples were collected from the children immediately after admission,3d and 7d.Blood was placed in a tube,placed until blood coagulation was obtained,and serum was separated and stored at-20℃ for use.3.Combined diagnosis of three of the five indicators: hs-CRP,PCT and SAA,IL-6,PCT and hs-CRP,WBC,hs-CRP and SAA,WBC,IL-6 and SAA,WBC,IL-6 and PCT,IL-6,PCT and SAA,WBC,hs-CRP and PCT,WBC,hs-CRP and IL-6,WBC,PCT and SAA,hs-CRP,SAA and IL-6.The sensitivity of pediatric infectious pneumonia was 81.2%,83.7%,79.6%,80.1%,79.8%,74.9%,77.2%,78.1%,75.7%,78.3%,respectively,and WBC and IL-6combined with SAA showed the highest sensitivity.The specificity was 87.5%,86.9%,84.3%,82.2%,85.6%,84.7%,85.4%,79.6%,81.6%,82.2%,respectively,among which WBC and IL-6 combined with PCT had the highest specificity.4.Statistical analysis: SPSS22.0 statistical software was used for statistical test,and t test was used for comparison between groups;The value of WBC,CRP,PCT,IL-6 and SAA levels in the diagnosis of bacterial or viral pneumonia was analyzed by ROC curve using χ2test,and P <0.05 was considered significant difference.Results1.There were no significant differences in age,gender and BMI among the three groups(P >0.05).The body temperature of the children in the bacterial pneumonia group and the viral pneumonia group was significantly higher than that in the control group(P <0.05).The five indexes in the bacterial pneumonia group were higher than those in the control group at admission and 3 days after admission,and WBC and SAA returned to normal at 7 days after admission.On admission of viral pneumonia,except for normal WBC,the other four indicators were all higher than the control group.WBC of the viral pneumonia was also higher than the control group after 3 days of admission.WBC and SAA of the viral pneumonia returned to normal levels on 7 days after admission.2.Pairwise diagnosis of five indicators: Pair combination of WBC and hs-CRP,WBC and PCT,WBC and IL-6,WBC and SAA,hs-CRP and PCT,hs-CRP and IL-6,hs-CRP and SAA,PCT and IL-6,PCT and SAA,and IL-6 and SAA respectively showed a sensitivity of78.3%,74.6%,77.9%,78.1%,74.2% for the diagnosis of infectious pneumonia in children.The sensitivity of hs-CRP combined with SAA was the highest.The specificity of WBC combined with PCT was 79.2%,81.3%,84.6%,81.2%,80.9%,81.2%,83.8%,83.9%,76.1%,84.5%,respectively.3.Combined diagnosis of three of the five indicators: hs-CRP,PCT and SAA,IL-6,PCT and hs-CRP,WBC,hs-CRP and SAA,WBC,IL-6 and SAA,WBC,IL-6 and PCT,IL-6,PCT and SAA.The sensitivity of pediatric infectious pneumonia was 81.2%,83.7%,79.6%,80.1%,79.8%,74.9%,77.2%,78.1%,75.7%,78.3%,respectively,and IL-6 and PCT combined with hs-CRP showed the highest sensitivity.The specificity was 87.5%,86.9%,84.3%,82.2%,85.6%,84.7%,85.4%,79.6%,81.6%,82.2%,respectively,among which hs-CRP and PCT combined with SAA had the highest specificity.4.Combined diagnosis of four of the five indicators: WBC,hs-CRP,PCT and SAA;IL-6,hs-CRP,PCT and SAA;WBC,IL-6,hs-CRP and PCT;WBC,IL-6,hs-CRP and SAA;WBC,IL-6,SAA and PCT.The sensitivity of pediatric infectious pneumonia was 82.4%,83.1%,84.6%,86.9% and 84.3%,respectively,and WBC and IL-6 and hs-CRP combined with SAA showed the highest sensitivity.The specificity of WBC,IL-6 and hs-CRP combined with PCT were 85.9%,85.7%,86.8%,85.1% and 86.7%,respectively.5.Combined diagnosis of five indicators: The sensitivity and specificity of the combined diagnosis of five indicators of WBC,hs-CRP,PCT,IL-6 and SAA in children with infectious pneumonia were 94.7% and 92.8%(P <0.05).Conclusion1.The levels of WBC,hs-CRP,PCT,IL-6 and SAA in children in bacterial pneumonia group were significantly higher than those in viral pneumonia group and control group.2.The levels of IL-6 in viral pneumonia group were significantly higher than those in control group,but there was no significant difference between WBC,hs-CRP,PCT,SAA and control group.3.Thesensitivity and specificity of combination with WBC,hs-CRP,PCT,IL-6 and SAA were the highest in the detection of children’s infectious pneumonia,which could be used in clinical practice. |
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