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目的探讨高浓度血清铁蛋白和肌红蛋白检测在诊断儿童军团菌肺炎中的诊断价值及其浓度变化对病情的评估。方法以本院2010年7月-2011年7月诊断为军团菌肺炎的35例患儿为试验组。选择同期诊断为链球菌肺炎患儿28例为对照组。比较2组患儿血清铁蛋白、肌红蛋白水平的差异及联合检查时对军团菌肺炎患儿诊断的敏感性、特异性以及病程中的血清浓度变化。结果试验组患儿血清铁蛋白水平显著高于对照组(P<0.01),试验组35例患儿中超过25%(9例)的患儿血清铁蛋白水平持续在600μg.L-1,超过正常值上限(正常值上限274μg.L-1)2倍多,并且在病程中持续不降,患儿病情危重,病死率较高。血清肌红蛋白水平2组比较无统计学差异(P>0.05)。血清铁蛋白与肌红蛋白联合检查对儿童军团菌肺炎诊断的敏感性、特异性均显著高于该2项单独检测指标(P<0.05,0.01)。结论高水平血清铁蛋白可能是儿童军团菌肺炎中一项特异性升高的实验室指标,对病情评估有较高的临床指导价值,与肌红蛋白联合检测可提高对军团菌肺炎诊断的阳性率。
Objective To investigate the diagnostic value of high-density serum ferritin and myoglobin in the diagnosis of Legionella pneumonia in children and the assessment of the changes in the concentration of serum ferritin and myoglobin. Methods 35 cases of Legionella pneumonia diagnosed in our hospital from July 2010 to July 2011 were selected as experimental group. Select the same period diagnosed as streptococcal pneumonia in 28 children as control group. The differences of serum ferritin and myoglobin levels between the two groups were compared. The sensitivity, specificity and duration of serum concentration changes of the patients with Legionella pneumonia in the combination examination were also compared. Results The level of serum ferritin in the experimental group was significantly higher than that in the control group (P <0.01). The serum ferritin level in the 35% of the 35 cases in the experimental group continued to be 600 μg.L-1 The upper limit of normal (upper limit of normal 274μg.L-1) more than 2 times, and in the course of the disease continued to decline, critically ill children, high mortality. There was no significant difference in serum myoglobin level between the two groups (P> 0.05). The sensitivity and specificity of combined detection of serum ferritin and myoglobin in children with Legionella pneumonia were significantly higher than those of the two separate tests (P <0.05, 0.01). Conclusions High level of serum ferritin may be a specific laboratory marker for Legionella pneumonia in children. It has a high clinical value in the evaluation of the disease. Combined with myoglobin detection can improve the diagnosis of Legionella pneumonia rate.