临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (8): 575-.doi: 10.3969/j.issn.1000-3606.2017.08.004

• 呼吸系统疾病专栏 • 上一篇    下一篇

联合血降钙素原、脑钠肽、D- 二聚体及PCIS 评分对评估儿童重症肺炎预后的价值

郭玮1,2, 何煜婷1, 邵琦1, 田曼1   

  1. 1 . 南京医科大学附属儿童医院呼吸科(江苏南京 210008);2 . 扬州大学附属医院儿科(江苏扬州 225001)
  • 收稿日期:2017-08-15 出版日期:2017-08-15 发布日期:2017-08-15
  • 通讯作者: 田曼 E-mail:tmsweet@163 .com

Value of combining PCT, BNP, D-dimer and PCIS score in predicting the prognosis of severe pediatric pneumonia#br#  

 GUO Wei 1,2, HE Yuting1, SHAO Qi1, TIAN Man1   

  1. 1. Department of respiration, Children's Hospital Affiliated to Nanjing Medical University,Nanjing 210008, Jiangsu, China ;2. Department of Paediatrics, Affiliated Hospital of Yangzhou University, Yangzhou 225001, Jiangsu, China
  • Received:2017-08-15 Online:2017-08-15 Published:2017-08-15

摘要:  目的 评价早期联合血降钙素原(PCT)、脑钠肽(BNP)、D-二聚体(DD)以及PCIS评分在评估儿童重症肺 炎预后中的价值。方法 选取重症肺炎患儿80例作为研究对象,其中男49例、女31例,中位年龄7.5个月(1~156个月), 根据患儿病情的最终转归分为治愈组和预后不良组;记录患儿入住儿童重症监护病房(PICU)24 h内的PCIS分值和PCT、 BNP、DD数值,对上述指标绘制各自的受试者工作特征曲线(ROC曲线),比较各自的曲线下面积(AUC)。 同时联合这四 项指标绘制ROC曲线,并与各单独指标的AUC比较,评价联合诊断的优劣。结果 入住PICU 24 h内的PCT、BNP、DD水 平及PCIS各自的AUC均介于0.7~0.9之间,而联合这四种指标的ROC曲线的AUC为0.932,灵敏度和特异度均有所提高。 结论 联合PCIS评分、BNP、降钙素原、DD水平可以提高对儿童重症肺炎预后评估的准确率。

Abstract:  Objective To evaluate the value of combining PCT, BNP, D-Dimer and PCIS score in predicting the prognosis of pediatric severe pneumonia in the early stage. Methods 80 cases of children with severe pneumonia were selected, 49 cases were boys , 31 cases were girls, with a  median age of 7.5 months (1 month to 156 months). According to the final outcome, the cases are divided into treatment group and poor prognosis group. The score of PCIS, PCT, BNP and D-dimer within 24 hours after admission were recorded. According to the indicators, ROC curve was drawn independently and integrated with the four indicators,and the corresponding areas under ROC curve (AUC) were calculated to compare the accuracy of the assessment. Results The AUC of PCIS, PCT, BNP and D-dimer were between 0.7 and 0.9. The ROC curve integrated the four indicators showed the AUC were 0.932, which improved sensitivity and specificity. Conclusions The integration of PCIS, PCT, BNP and D-Dimer could improve the accuracy of prediction in the prognosis of severe pediatric pneumonia.