摘要
目的 分析血常规指标联合检测在小儿肺炎分型中的应用价值.方法 收集余庆县人民医院儿科 2022 年 1 月—2023 年 12 月收治的 120 例小儿肺炎患儿的临床资料,根据病原体类型分为细菌性肺炎组(50 例)、病毒性肺炎组(30 例)、支原体肺炎组(40 例).采集血液样本后使用全自动血细胞分析仪检测血常规指标[白细胞计数(WBC)、中性粒细胞比例(NEU%)].将临床诊断结果作为参照依据,分析WBC、NEU%单独与联合应用对细菌性肺炎、病毒性肺炎、支原体肺炎的鉴别诊断效能,比较敏感度、特异度、阳性预测值、阴性预测值的差异.结果 细菌性肺炎组的WBC、NEU%水平均显著高于病毒性肺炎组和支原体肺炎组[WBC(×109/L):12.31±1.19比6.52±1.02、8.93±1.10;NEU%:(67.23±7.34)%比(29.04±2.53)%、(53.11±5.10)%;均P＜0.05],且支原体肺炎组的WBC、NEU%水平均显著高于病毒性肺炎组(均P＜0.05).以临床诊断为参照,WBC、NEU%联合应用鉴别诊断小儿肺炎分型的敏感度、特异度、阳性预测值、阴性预测值均显著高于单独检测(细菌性肺炎:敏感度:83.33%比 73.33%、66.67%,特异度:85.00%比 70.00%、70.00%,阳性预测值:89.29%比 78.57%、76.92%,阴性预测值:77.27%比 63.64%、58.33%;病毒性肺炎:敏感度:70.00%比 55.00%、50.00%,特异度:60.00%比 40.00%、50.00%,阳性预测值:77.78%比 64.71%、66.67%,阴性预测值:50.00%比 30.77%、33.33%;支原体肺炎:敏感度:54.17%比 33.33%、37.50%,特异度:50.00%比37.50%、37.50%,阳性预测值:61.90%比44.44%、38.74%,阴性预测值:42.11%比27.27%、31.36%;均P＜0.05).结论 不同类型小儿肺炎患儿的血常规指标变化明显,可以为区分病原体类型提供一定参考,且多指标联合检测的诊断效能高于单独检测,具有较高的推广使用价值.
Abstract
Objective To analyze the application value of combined detection of blood routine test indexes in the classification of pediatric pneumonia.Methods The clinical data of 120 children with pediatric pneumonia admitted to pediatrics department of Yuqing County People's Hospital from January 2022 to December 2023 were collected.The children were divided into bacterial pneumonia group(50 cases),viral pneumonia group(30 cases)and mycoplasma pneumonia group(40 cases)according to the pathogen type.After collecting blood samples,the blood routine indicators[white blood cell count(WBC)and neutrophil proportion(NEU%)]were detected using fully automated blood cell analyzer.Using clinical diagnostic results as reference,the differential diagnostic efficacies of WBC and NEU%alone and in combination for bacterial pneumonia,viral pneumonia and mycoplasma pneumonia were analyzed,and the differences in sensitivity,specificity,positive predictive value and negative predictive value were compared.Results The levels of WBC and NEU%in bacterial pneumonia group were higher than those in viral pneumonia group and mycoplasma pneumonia group[WBC(×109/L):12.31±1.19 vs.6.52±1.02,8.93±1.10;NEU%:(67.23±7.34)%vs.(29.04±2.53)%,(53.11±5.10)%;all P＜0.05],and the levels of WBC and NEU%in mycoplasma pneumonia group were higher than those in viral pneumonia group(both P＜0.05).Based on clinical diagnosis,the sensitivity,specificity,positive predictive value and negative predictive value of combined detection of WBC and NEU%for differential diagnosis of pediatric pneumonia subtypes were higher than those of WBC and NEU%alone(bacterial pneumonia:sensitivity:83.33%vs.73.33%,66.67%,specificity:85.00%vs.70.00%,70.00%,positive predictive value:89.29%vs.78.57%,76.92%,negative predictive value:77.27%vs.63.64%,58.33%;viral pneumonia:sensitivity:70.00%vs.55.00%,50.00%,specificity:60.00%vs.40.00%,50.00%,positive predictive value:77.78%vs.64.71%,66.67%,negative predictive value:50.00%vs.30.77%,33.33%;mycoplasma pneumonia:sensitivity:54.17%vs.33.33%,37.50%,specificity:50.00%,37.50%,37.50%,positive predictive value:61.90%,44.44%,38.74%,negative predictive value:42.11%,27.27%,31.36%;all P＜0.05).Conclusions The changes in blood routine indicators are more significant in the classification of pediatric pneumonia,which could provide certain reference for distinguishing the types of pathogenic bacteria.Moreover,the diagnostic efficacy of combined detection is higher than those of individual testing,and it has good promotional value in primary medical institutions.
维普
万方数据