摘要
目的 探讨小儿支气管肺炎患儿白细胞计数(WBC)与心肌酶谱变化及其疗效的关系.方法 选取我院2021年1月至2022年12月收治的80例小儿支气管肺炎患儿为研究对象,根据入院时患儿临床症状严重程度分为重症组(32例)和轻症组(48例),根据治疗7 d后的疗效将患儿分为疗效良好(59例)和疗效不良(21例)2个亚组.比较2组(入院时)及不同预后患儿(入院时、治疗3 d、7 d后)白细胞计数(WBC)、血清天门冬氨酸氨基转移酶(AST)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBDH)水平,分析入院时WBC、AST、CK-MB、α-HBDH水平与小儿支气管肺炎病情严重程度的相关性,偏回归分析小儿支气管肺炎疗效不良的危险因素,受试者工作特征曲线(ROC)分析治疗3 d后WBC、AST、CK-MB、α-HBDH水平联合预测小儿支气管肺炎疗效不良的价值.结果 入院时重症组WBC、AST、CK-MB、α-HBDH水平高于轻症组(P＜0.05);相关性分析结果显示,入院时WBC、AST、CK-MB、α-HBDH水平与病情严重程度均呈正相关(P＜0.05);治疗3 d、7 d后疗效不良患儿WBC、AST、CK-MB、α-HBDH 水平均高于疗效良好患儿(P＜0.05);偏回归分析显示,治疗3 d后WBC(＞10.61 ×109/L)、AST(＞50.66 U/L)、CK-MB(＞27.99 U/L)、α-HBDH(＞212.48 U/L)水平是小儿支气管肺炎患儿疗效不佳的危险因素(P＜0.05);ROC分析结果显示,治疗3 d后WBC、AST、CK-MB、α-HBDH水平联合预测小儿支气管肺炎疗效不佳的AUC为0.851,最佳预测敏感度、特异度分别为90.53％、75.62％.结论 小儿支气管肺炎患儿WBC、AST、CK-MB、α-HBDH表达水平与病情程度呈正相关,且治疗3 d后各指标联合在预测疗效不良方面具有较高预测效能.
Abstract
Objective To explore the relationship between white blood cell count(WBC)and changes in myocardial enzyme spectrum in children with bronchopneumonia and their therapeutic effects.Methods A total of 80 children with bronchopneumonia admitted to our hospital from January 2021 to December 2022 were selected as research objects.Accord-ing to the severity of clinical symptoms at admission,the children were divided into a severe group(32 cases)and a mild group(48 cases),and were divided into two subgroups:59 cases with good efficacy and 21 cases with poor efficacy accord-ing to the efficacy after 7 days of treatment.The levels of white blood cell count(WBC),serum aspartate aminotransferase(AST),creatine kinase isoenzyme(CK-MB)and α-hydroxybutyrate dehydrogenase(α-HBDH)were compared between the 2 groups(on admission)and the children with different prognosis(on admission,3 and 7 days after treatment).The correlation between the level of WBC,AST,CK-MB and α-HBDH at admission and the severity of bronchopneumonia in children was analyzed,and partial regression analysis was used to analyze the risk factors for poor efficacy in pediatric bron-chopneumonia.The value of combining WBC,AST,CK-MB,and α-HBDH levels after 3 days of treatment was analyzed u-sing the receiver operating characteristic curve(ROC)to predict poor efficacy in pediatric bronchopneumonia.The ROC a-nalysis results showed that the AUC of the combination of WBC,AST,CK-MB,and α-HBDH levels predicting poor efficacy in pediatric bronchopneumonia after 3 days of treatment was 0.851,the best predictive sensitivity and specificity were 90.53％and 75.62％,respectively.Results The levels of WBC,AST,CK-MB and α-HBDH in severe group were higher than those in mild group(P＜0.05);correlation analysis showed that WBC,AST,CK-MB and α-HBDH levels were posi-tively correlated with the severity of the disease at admission(P＜0.05);after 3 and 7 days of treatment,the WBC,AST,CK-MB,and α-HBDH levels in children with poor efficacy were on average higher than those in children with good efficacy(P＜0.05);partial regression analysis showed that WBC(＞10.61 x 109/L),AST(＞50.66 U/L),CK-MB(＞27.99 U/L),andα-HBDH(＞212.48 U/L)levels after 3 days of treatment were risk factors for poor efficacy in pediatric bronchopneumonia(P＜0.05);the ROC analysis results showed that the AUC of poor efficacy predicted by the combination of WBC,AST,CK-MB,and α-HBDH levels after 3 days of treatment in pediatric bronchopneumonia was 0.851,and the best predictive sensi-tivity and specificity were 90.53％and 75.62％,respectively.Conclusion The expression levels of WBC,AST,CK-MB,and α-HBDH in children with bronchopneumonia are positively correlated with the severity of the disease,and the combina-tion of various indicators after 3 days of treatment has high predictive power in predicting poor efficacy.
维普
万方数据