小儿肺炎急性期血清PCT hs-CRP水平与心肌损害程度的关系

doi:10.3969/j.issn.1006-6233.2022.09.09

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Abstract Objective: To analyze the relationship between levels of serum PCT and hs-CRP and the degree of myocardial damage in children with acute stage of pneumonia. Methods: 137 children with acute stage of pediatric pneumonia were analyzed. Among them, 82 cases with myocardial damage were enrolled in the myocardial damage group and 55 cases without the occurrence of myocardial damage were included in the non-myocardial damage group. According to the degree of myocardial damage, the children were divided into 33 cases in the mild group, 28 cases in the moderate group, and 21 cases in the severe group. The baseline data and levels of serum myocardial damage markers [creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI)], serum PCT, and hs-CRP were analyzed in the myocardial damage group, and non-myocardial damage group, and the changes in levels of serum PCT and hs-CRP in mild, moderate and severe groups were compared. Pearson correlation analysis was used to analyze the correlation between levels of serum PCT and hs-CRP and CK-MB and cTnI in children. The receiver operating characteristic (ROC) curve was adopted to analyze the diagnostic value of serum PCT, hs-CRP, and the combination of the two in predicting the occurrence of myocardial damage in children with acute stage of pneumonia. Results: There were no statistical differences in gender, age, and time from onset to admission between the two groups (P>0.05). The levels of serum CK-MB and cTnI in the myocardial damage group were significantly higher than those in the non-myocardial damage group (P<0.05). The levels of serum PCT and hs-CRP were significantly higher in the myocardial damage group than those in the non-myocardial damage group (P<0.05). The differences in serum PCT and hs-CRP levels among the three groups of children with different myocardial damage degrees were statistically significant, among which the levels were significantly lower in the mild group than those in the moderate group and severe group (P<0.05) and were significantly lower in the moderate group than those in the severe group (P<0.05). Serum PCT and hs-CRP levels in children with acute stage of pneumonia complicated with myocardial damage were positively correlated with serum CK-MB levels (r=0.621, 0.778, all P<0.001), and were positively correlated with serum cTnI level (r=0.501, 0.6668, all P<0.001). Logistic regression analysis revealed that serum PCT and hs-CRP levels were correlated with myocardial damage in children at the acute stage (P<0.05). ROC analysis showed that the AUC values of serum PCT, hs-CRP, and their combination were 0.858, 0.914, and 0.955 respectively in the diagnosis of occurrence of myocardial damage in children with acute stage of pneumonia (all P<0.05), and the sensitivities were 85.37%, 90.24%, and 93.90% and the specificities were 72.73%, 83.64%, and 70.91% respectively. Conclusion: The high expressions of serum PCT and hs-CRP may indicate myocardial damage in children with acute stage of pneumonia, and they can be used for clinical auxiliary diagnosis.

Key words： Pediatric pneumonia Serum PCT Serum hs-CRP Myocardial damage

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.09.09 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I9/1452

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