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目的:探讨血清可溶性CD14分子亚型(presepsin)和血清降钙素原(PCT)在儿童细菌性肺炎诊治中的应用价值。方法:选取2015年7月至2016年2月我院收治的确诊细菌性肺炎儿童42例为疾病组,另选取30例同期健康体检儿童为对照组。疾病组采用阿奇霉素治疗。应用酶联免疫吸附法(ELISA)检测对照组入选时以及疾病组治疗前和治疗7 d的血清presepsin和PCT水平,统计疾病组阿奇霉素治疗效果,比较不同疗效患者治疗前和治疗7 d的血清presepsin和PCT水平,采用Spearman秩相关分析法分析血清presepsin和PCT水平与其治疗有效率的关系,并采用受试者操作特性曲线(ROC)分析血清presepsin和血清PCT分别诊断儿童细菌性肺炎的准确性。结果:与对照组比较,疾病组治疗前后的血清presepsin和PCT水平均提高;与治疗前比较,疾病组治疗7 d的血清presepsin和PCT水平降低(P<0.05)。疾病组治疗有效率为85.71%。与治疗有效患者比较,治疗无效患者治疗前后的血清presepsin和PCT水平升高(P<0.05)。Spearman秩相关分析结果显示,血清presepsin和PCT水平与儿童细菌性肺炎治疗有效率均呈负相关(r=-0.828,-0.772,P<0.05)。ROC分析结果显示,血清presepsin诊断儿童细菌性肺炎的价值优于血清PCT。结论:儿童细菌性肺炎血清presepsin和血清降钙素原较高并与其疗效相关,且两者用于儿童细菌性肺炎诊断的价值良好,其中以血清presepsin诊治儿童细菌性肺炎的价值更高,更适用于儿童细菌性肺炎的诊治。
Objective: To investigate the value of serum soluble CD14 molecular presepsin and serum procalcitonin (PCT) in diagnosis and treatment of bacterial pneumonia in children. Methods: Forty-two children diagnosed with bacterial pneumonia admitted from July 2015 to February 2016 in our hospital were selected as the disease group and 30 healthy children were selected as the control group. Disease group treated with azithromycin. Serum presepsin and PCT levels of the control group before treatment and 7 days of treatment were detected by enzyme-linked immunosorbent assay (ELISA), and the effect of azithromycin in the disease group was statistically analyzed. The serum presepsin levels before treatment and 7 days after treatment were compared And PCT levels. Spearman rank correlation analysis was used to analyze the relationship between serum presepsin and PCT levels and the therapeutic efficiency. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic accuracy of serum presepsin and serum PCT in children with bacterial pneumonia. Results: Compared with the control group, the serum presepsin and PCT levels in the disease group were significantly increased before and after treatment. Compared with those before the treatment, the levels of serum presepsin and PCT in the disease group were decreased on the 7th day (P <0.05). Disease treatment efficiency was 85.71%. Compared with patients with effective treatment, patients with ineffective treatment had elevated serum presepsin and PCT levels before and after treatment (P <0.05). Spearman rank correlation analysis showed that serum presepsin and PCT levels were negatively correlated with the efficacy of treatment of bacterial pneumonia in children (r = -0.828, -0.772, P <0.05). ROC analysis showed that the value of serum presepsin in diagnosing bacterial pneumonia in children was superior to serum PCT. CONCLUSIONS: The serum presepsin and serum procalcitonin were higher in children with bacterial pneumonia and related to their curative effect. Both were valuable for the diagnosis of bacterial pneumonia in children, and the value of serum presepsin in diagnosis and treatment of bacterial pneumonia in children was higher. For children with bacterial pneumonia diagnosis and treatment.