血清suPAR、PCT、CRP水平在小儿重症肺炎鉴别诊断中的效能分析

摘要 目的：分析血清可溶性尿激酶型纤溶酶原激活物受体（soluble urokinase-type plasminogen activator receptor，suPAR）、降钙素原（procalcitoni， PCT）、C反应蛋白（C-reaction protein，CRP）水平在小儿重症肺炎鉴别诊断中的效能，以更好地评估患儿的病情严重程度，从而指导治疗及降低重症肺炎的死亡率。方法：选取贵阳市第二人民医院及贵阳市儿童医院在2020年1月至2020年12月期间收治入院的80例社区获得性肺炎患儿作为研究对象，其中轻症患儿和重症患儿各40例。检测患儿入院时白细胞计数（white blood count，WBC）、中性粒细胞（neutrophil，N）、CRP、PCT和suPAR水平。采用受试者工作特征曲线（receiver operating characteristic curve，ROC）比较各指标对小儿肺炎病情严重程度的诊断效能。结果：重症组患儿WBC、N以及血清PCT、CRP、suPAR水平均明显高于轻症组患儿，差异具有统计学意义（P<0.05）。Pearson相关分析结果表明，血清suPAR水平与WBC、N、PCT和CRP水平均存在明显正相关性（P<0.05）。ROC曲线结果表明，血清suPAR诊断小儿肺炎病情严重程度的效果最佳，曲线下面积（area under curve，AUC）为0.866（95%CI：0.780~0.951），最佳截断值为1.8，敏感度、特异度和约登指数分别为85.73 %、83.52 %和69.25 %。结论：早期检测血清suPAR能够预测小儿获得性社区肺炎病情严重程度，效果优于WBC、N以及血清PCT、CRP等指标。

Efficacy Analysis of Serum suPAR, PCT and CRP Levels in Differential Diagnosis of Severe Pneumonia in Children

ABSTRACT Objective: To analyze serum soluble urokinase type plasminogen activator receptor (suPAR), procalcitoni (PCT), C-reaction protein (C-reaction) Objective to evaluate the efficacy of CRP level in the differential diagnosis of severe pneumonia in children, so as to better evaluate the severity of the disease, guide the treatment and reduce the mortality of severe pneumonia. Methods: 80 cases of children with acquired pneumonia admitted to Guiyang Second People''s Hospital and Guiyang children''s Hospital from January 2020 to December 2020 were selected as the research objects, including 40 cases of mild and 40 cases of severe children. White blood count (WBC), neutrophil (N), CRP, PCT and suPAR levels were detected at admission. Receiver operating characteristic curve (ROC) was used to compare the diagnostic efficacy of each index on the severity of pneumonia in children. Results: The levels of WBC, N, PCT, CRP and suPAR in the severe group were significantly higher than those in the mild group(P<0.05). Pearson correlation analysis showed that serum suPAR levels were positively correlated with WBC, N, PCT and CRP levels(P<0.05). The area under curve(AUC) was 0.866 (95% CI: 0.780-0.951), the best cut-off value was 1.8, and the sensitivity, specificity and Youden index were 85.73 %, 83.52 % and 69.25 %, respectively. Conclusion: Early detection of serum suPAR can predict the severity of acquired community pneumonia in children, and the effect is better than WBC, N, PCT, CRP and other indicators.