Application of multi-index combined detection in the etiological diagnosis of bacterial pneumonia of children

doi:10.3877/cma.j.issn.1674-1358.2020.05.011

Abstract

Abstract:

Objective

To investigate the diagnostic value of serum procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), interleukin-6 (IL-6), P2X7 receptor and CD64 combined detection in children with bacteria pneumonia.

Methods

Total of 140 children with pneumonia admitted to Shenzhen Longhua District Central Hospital from October 2017 to October 2018 were selected and divided into bacterial group (60 cases), mycoplasma pneumoniae group (50 cases) and virus group (30 cases) according to different infectious pathogens. While, 50 healthy children who had physical examination in our hospital during the same period were selected as healthy control group. The levels of serum PCT, CRP, WBC and IL-6, the expressions of P2X7 receptor and CD64 in the four groups were measured and compared, respectively. The values of these indicators in the diagnosis of bacterial pneumonia in children were analyzed by receiver operating characteristic (ROC) curve.

Results

The serum PCT, CRP and IL-6 levels of children in bacteria group, mycoplasma pneumoniae group, virus group and healthy control group showed a gradually decreasing trends (F = 24.935, 31.942, 21.764, all P < 0.001). WBC level in cases of bacterial group was higher than that of cases in mycoplasma pneumoniae group, virus group and healthy control group (t = 12.219, 8.942, 15.053, all P < 0.001). There was no significant difference in WBC level between cases of mycoplasma pneumoniae group and virus group (t = 1.010, P = 0.316). The expression levels of P2X7 receptor and CD64 of cases in bacteria group were significantly higher than those of mycoplasma pneumoniae group, virus group and healthy control group. Moreover, the expression levels of P2X7 receptor and CD64 in serum of cases in mycoplasma pneumoniae group and virus group were significantly higher than that of healthy control group (all P < 0.001). The expression levels of P2X7 receptor and CD64 in serum between cases in mycoplasma pneumoniae group and virus group were not significantly different (t = 0.525, P = 0.601; t = 1.629, P = 0.107). The ROC curves showed that the area of under the curve of serum PCT, CRP, WBC, IL-6, P2X7 receptors and CD64 combined detection (0.924), sensitivity (0.92) and specificity (0.93) were significantly higher than the separate detection indexes (PCT: 0.728, 0.74, 0.69; CRP: 0.719, 0.72, 0.70; WBC: 0.687, 0.70, 0.65; IL-6: 744, 0.78, 0.72; P2X7 receptors: 0.659, 0.64, 0.61; CD64: 0.702, 0.71, 0.68).

Conclusion

The combined detection of serum PCT, CRP, WBC, IL-6, P2X7 receptor and CD64 was of high diagnostic value for children with bacterial pneumonia.

Key words: Pediatric pneumonia, Procalcitonin, C-reactive protein, White blood cell count, Interleukin-6, P2X7 receptor, CD64

Fusheng Wen, Biqi Zhang, Jiajun. Chang. Application of multi-index combined detection in the etiological diagnosis of bacterial pneumonia of children[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2020, 14(05): 418-423.

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References 27

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组别	例数	PCT（ng/ml）	CRP（mg/L）	WBC（× 10⁹/L）	IL-6（ng/L）
细菌组	60	3.28 ± 0.86	40.58 ± 12.18	12.47 ± 2.28	8.28 ± 3.10
肺炎支原体组	50	0.24 ± 0.10	25.13 ± 10.02	7.84 ± 1.54	5.83 ± 2.15
病毒组	30	0.17 ± 0.06	7.23 ± 2.19	8.22 ± 1.77	3.65 ± 1.34
健康对照组	50	0.10 ± 0.01	5.44 ± 1.15	7.14 ± 1.13	1.64 ± 0.98
F值		24.935	31.942	14.785	21.764
P值		< 0.001	< 0.001	< 0.001	< 0.001
t₁值		24.837	7.171	12.219	4.720
P₁值		< 0.001	< 0.001	< 0.001	< 0.001
t₂值		19.728	14.837	8.942	7.807
P₂值		< 0.001	< 0.001	< 0.001	< 0.001
t₃值		26.125	20.310	15.053	14.543
P₃值		< 0.001	< 0.001	< 0.001	< 0.001
t₄值		3.472	9.625	1.010	4.995
P₄值		0.001	< 0.001	0.316	0.000
t₅值		9.850	13.805	2.591	12.539
P₅值		< 0.001	< 0.001	0.011	< 0.001
t₆值		8.097	4.794	3.334	7.720
P₆值		< 0.001	< 0.001	0.001	< 0.001

组别	例数	PCT（ng/ml）	CRP（mg/L）	WBC（× 10⁹/L）	IL-6（ng/L）
细菌组	60	3.28 ± 0.86	40.58 ± 12.18	12.47 ± 2.28	8.28 ± 3.10
肺炎支原体组	50	0.24 ± 0.10	25.13 ± 10.02	7.84 ± 1.54	5.83 ± 2.15
病毒组	30	0.17 ± 0.06	7.23 ± 2.19	8.22 ± 1.77	3.65 ± 1.34
健康对照组	50	0.10 ± 0.01	5.44 ± 1.15	7.14 ± 1.13	1.64 ± 0.98
F值		24.935	31.942	14.785	21.764
P值		< 0.001	< 0.001	< 0.001	< 0.001
t₁值		24.837	7.171	12.219	4.720
P₁值		< 0.001	< 0.001	< 0.001	< 0.001
t₂值		19.728	14.837	8.942	7.807
P₂值		< 0.001	< 0.001	< 0.001	< 0.001
t₃值		26.125	20.310	15.053	14.543
P₃值		< 0.001	< 0.001	< 0.001	< 0.001
t₄值		3.472	9.625	1.010	4.995
P₄值		0.001	< 0.001	0.316	0.000
t₅值		9.850	13.805	2.591	12.539
P₅值		< 0.001	< 0.001	0.011	< 0.001
t₆值		8.097	4.794	3.334	7.720
P₆值		< 0.001	< 0.001	0.001	< 0.001

组别	例数	P2X7受体（pg/ml）	CD64（pg/ml）
细菌组	60	67.32 ± 7.10	41.71 ± 4.82
肺炎支原体组	50	53.49 ± 6.01	30.49 ± 3.82
病毒组	30	54.22 ± 6.05	31.92 ± 3.77
健康对照组	50	42.32 ± 5.11	20.19 ± 2.83
F值		24.293	31.256
P值		< 0.001	< 0.001
t₁值		10.897	13.333
P₁值		< 0.001	< 0.001
t₂值		8.651	9.727
P₂值		< 0.001	< 0.001
t₃值		20.803	27.815
P₃值		< 0.001	< 0.001
t₄值		0.525	1.629
P₄值		0.601	0.107
t₅值		10.020	17.595
P₅值		< 0.001	< 0.001
t₆值		9.406	15.814
P₆值		< 0.001	< 0.001

组别	例数	P2X7受体（pg/ml）	CD64（pg/ml）
细菌组	60	67.32 ± 7.10	41.71 ± 4.82
肺炎支原体组	50	53.49 ± 6.01	30.49 ± 3.82
病毒组	30	54.22 ± 6.05	31.92 ± 3.77
健康对照组	50	42.32 ± 5.11	20.19 ± 2.83
F值		24.293	31.256
P值		< 0.001	< 0.001
t₁值		10.897	13.333
P₁值		< 0.001	< 0.001
t₂值		8.651	9.727
P₂值		< 0.001	< 0.001
t₃值		20.803	27.815
P₃值		< 0.001	< 0.001
t₄值		0.525	1.629
P₄值		0.601	0.107
t₅值		10.020	17.595
P₅值		< 0.001	< 0.001
t₆值		9.406	15.814
P₆值		< 0.001	< 0.001

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