Analysis of correlation between level of serum inflammatory markers and degree of myocardial damage in children with pneumonia
Objective To investigate the correlation between procalcitonin(PCT),interleukin-6(IL-6),hypersensi-tive C-reactive protein(hs-CRP)and myocardial damage in children with pneumonia.Methods Totally 153 chil-dren with pneumonia admitted from April 2020 to April 2023 in Kaifeng Central Hospital were divided into the MD group(93 cases)and the non-MD group(60 cases)according to whether myocardial damage occurred during hospitaliza-tion.Among the children in the MD group,37 cases were classified as grade Ⅱ,31 cases as grade Ⅲ,and 25 cases as grade Ⅳ according to the New York College of Cardiology(NYHA).General data and levels of PCT,IL-6 and hs-CRP were compared between the two groups.The correlation between different NYHA grades,troponin or creatine kinase isoenzymes of PCT,IL-6 and hs-CRP was analyzed.ROC was used to analyze the effectiveness of each variable in pre-dicting myocardial injury.Results Troponin(156.92±43.95)pg/mL and creatine kinase isoenzyme(56.92±13.47)U/L in MD group were higher than those in non-MD group(73.27±14.94)pg/mL,(18.47±3.59)U/L.The length of hospital stay(13.48±3.35)d was longer than that of the non-MD group(9.36±2.57)d(P＜0.05).PCT(10.58±1.48)pg/L,IL-6(293.27±78.28)pg/mL and hs-CRP(16.37±3.22)mg/mL in MD group were higher than those in non-MD group(7.13±1.26)pg/L,(215.28±56.93)pg/mL,(9.74±1.47)mg/mL(P＜0.05);the PCT(16.27±1.37)pg/L,IL-6(336.83±57.84)pg/mL and hs-CRP(21.97±4.95)mg/mL in NYHA Ⅳ group were higher than those in Grade Ⅲ group(12.39±1.64)pg/L,(289.37±66.82)pg/mL,(17.94±2.69)mg/mL;grade Ⅲ children were higher than grade Ⅱ children(7.67±1.39)pg/L,(243.34±59.47)pg/mL,(12.34±3.59)mg/mL(P＜0.05).Correlation analysis showed that PCT,IL-6 and hs-CRP were positively correlated with troponin(r=0.572,0.482,0.588,P＜0.05)and creatine kinase isoenzyme(r=0.536,0.513,0.567,P＜0.05).ROC analy-sis showed that the AUC value of PCT for predicting myocardial damage in children with pneumonia was 0.875,the opti-mal cut-off value was 9.72 pg/L,the sensitivity was 82.85％,and the specificity was 86.79.IL-6 AUC value was 0.819,the optimal cut-off value was 258.64 pg/mL,the sensitivity was 76.59％,and the specificity was 82.54％.The AUC value of hs-CRP was 0.853,the optimal cut-off value was 14.27 mg/mL,the sensitivity was 81.73％,and the specificity was 84.67％.The combined AUC value of the three was 0.943,the sensitivity was 93.73％,and the specifici-ty was 94.73％.Conclusion PCT,IL-6 and hs-CRP are correlated with the degree of myocardial damage in children with pneumonia,and can be used as a reference index to predict myocardial damage.
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