2020 年第 7 期 第 15 卷

血清降钙素原联合呼吸道病原体抗体检测对小儿肺炎的诊断价值分析

Diagnostic value of serum procalcitonin combined with antibody detection of respiratory pathogens in children with pneumonia

作者：王建斌袁慧聂晓伟刘东庭王燕

英文作者：Wang Jianbin Yuan Hui Nie Xiaowei Liu Dongting Wang Yan

单位：首都医科大学附属北京安贞医院检验科北京市心肺血管疾病研究所100029

英文单位：

关键词：小儿肺炎；呼吸道病原体抗体；血清降钙素原；诊断价值

英文关键词：Pediatricpneumonia；Respiratorypathogenantibody；Serumprocalcitonin；Diagnosticvalue

• 摘要：

• 目的探究应用血清降钙素原与呼吸道病原体抗体联合检测对小儿肺炎的诊断价值。方法选取2018年9月至2019年9月首都医科大学附属北京安贞医院筛查疑似肺炎患儿2 000例，均进行血清降钙素原和呼吸道病原体（甲型流感病毒、腺病毒、呼吸道合胞病毒、肺炎支原体、肺炎衣原体）抗体及影像学检测，对其诊断价值加以分析。结果2 000例疑似肺炎患儿通过实验室和影像学检查确诊1 384例。甲型流感病毒IgM联合降钙素原检测的诊断准确率为73.5%（161/219），明显高于前者单独检测［66.2%（145/219）］（χ2=4.296，P=0.038）；腺病毒IgM联合降钙素原检测的诊断准确率为69.6%（117/168），明显高于前者单独检测［61.3%（103/168）］（χ2=12.514，P＜0.001）；呼吸道合胞病毒IgM联合降钙素原检测的诊断准确率为77.9%（183/235），明显高于前者单独检测［71.5%（168/235）］（χ2=6.237，P=0.013）；肺炎支原体IgM联合降钙素原检测的诊断准确率为76.1%（255/335）,明显高于前者单独检测［71.0%（238/335）］（χ2=9.373，P=0.002）；肺炎衣原体IgM联合降钙素原检测的诊断准确率为79.9%（341/427），明显高于前者单独检测［75.4%（322/427）］（χ2=7.622，P=0.006）。呼吸道病原体（病毒、支原体、衣原体）IgM联合降钙素原检测的诊断准确率为76.4%（1 057/1 384），明显高于后者单独检测［70.5%（976/1 384）］（χ2=41.828，P＜0.001）。结论小儿肺炎应用血清降钙素原与呼吸道病原体抗体联合检测的诊断价值较高，可为临床疾病诊治提供依据。

• ObjectiveTo evaluate the diagnostic value of combined detection of procalcitonin(PCT) and antibody with respiratory pathogens in children with pneumonia. Methods From September 2018 to September 2019, 2 000 children with suspected pneumonia admitted to Beijing Anzhen Hospital, Capital Medical University were selected. 2 000 children with respiratory pathogens (influenza A virus, adenovirus, human respiratory syncytial virus, mycoplasma pneumoniae, chlamydophila pneumoniae) and imaging were detected. Results  Totally 1 384 children were confirmed by laboratory and imaging examination. The diagnostic accuracy of PCT combined with influenza A virus IgM was 73.5%(161/219), which was significantly higher than that of influenza A virus IgM alone［66.2%（145/219）］(χ2=4.296, P=0.038). The diagnostic accuracy of adenovirus IgM combined with PCT was 69.6%(117/168), which was significantly higher than that of adenovirus IgM alone［61.3%（103/168）］(χ2=12.514, P＜0.001). The diagnostic accuracy of human respiratory syncytial virus IgM combined with PCT was 77.9%(183/235), which was significantly higher than that of human respiratory syncytial virus IgM alone［71.5%（168/235）］(χ2=6.237, P=0.013). The diagnostic accuracy of mycoplasma IgM combined with procalcitonin was 76.1%(255/335), which was significantly higher than that of human respiratory syncytial virus IgM［71.0%（238/335）］(χ2=9.373, P=0.002). The diagnostic accuracy of the detection of chlamydia pneumoniae IgM combined with procalcitonin is 79.9%(341/427), which is significantly higher than that of Chlamydia pneumoniae IgM alone［75.4%（322/427）］(χ2=7.622, P=0.006). The diagnostic accuracy of respiratory tract pathogen IgM (influenza virus, human respiratory syncytial virus, mycoplasma) combined with PCT detection was 76.4%(1 057/1 384), which was significantly higher than that of procalcitonin detection alone［70.5%（976/1 384）］(χ2=41.828, P＜0.001). Conclusion Combined detection of PCT and antibody in children with pneumonia is of high diagnostic value.