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社区获得性重症肺炎儿童病毒感染与细菌感染时血小板参数的动态变化

Dynamics of platelet parameters in children with severe community-acquired pneumonia between viral and bacterial infections.

作者信息

Fan Chaonan, Mao Yiyang, Liu Jun, Gao Hengmiao, Fang Boliang, Li Rubo, Liu Gang, He Yushan, Qian Suyun

机构信息

Department of Pediatric Intensive Care Unit, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

National Clinical Research Center for Respiratory Diseases, Beijing, China.

出版信息

Transl Pediatr. 2024 Jan 29;13(1):52-62. doi: 10.21037/tp-23-441. Epub 2024 Jan 18.

Abstract

BACKGROUND

Changes in platelet parameters may vary according to the different pathogens. However, little is known about the differences in platelet parameters in children with severe community-acquired pneumonia (CAP) children of viral and bacterial infections.

METHODS

This was a single-center retrospective study that included 156 children with severe CAP. Dynamic changes in platelet parameters, including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT), were recorded at 24 h, 48 h, 72 h, and day 7 of admission, as well as at discharge.

RESULTS

At 72 h of admission, PLT in the viral infection group was significantly lower than that in the bacterial infection and bacterial and viral coinfections group. Meanwhile, the curve of changes in PLT (ΔPLT) in the viral infection group was clearly separated from the other two groups at this time point. Receiver operating characteristic (ROC) analysis showed that PLT at 72 h of admission could assist in distinguishing bacterial and viral infections in severe pneumonia children with the area under curve (AUC) value of 0.683 [95% confidence interval (CI): 0.561-0.805, P=0.007]. However, its sensitivity and specificity were not high, at 68% and 65%, respectively.

CONCLUSIONS

Although the diagnostic value of platelet parameters in bacterial and viral infection in children with severe CAP is limited, they are still expected to be combined with other indicators to provide a reference for timely treatment.

摘要

背景

血小板参数的变化可能因病原体不同而有所差异。然而,对于重症社区获得性肺炎(CAP)患儿中病毒感染和细菌感染时血小板参数的差异知之甚少。

方法

这是一项单中心回顾性研究,纳入了156例重症CAP患儿。记录入院后24小时、48小时、72小时、第7天以及出院时血小板参数的动态变化,包括血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)和血小板压积(PCT)。

结果

入院72小时时,病毒感染组的PLT显著低于细菌感染组以及细菌和病毒混合感染组。同时,此时病毒感染组的PLT变化曲线(ΔPLT)与其他两组明显分开。受试者工作特征(ROC)分析显示,入院72小时时的PLT有助于区分重症肺炎患儿的细菌和病毒感染,曲线下面积(AUC)值为0.683 [95%置信区间(CI):0.561 - 0.805,P = 0.007]。然而,其敏感性和特异性不高,分别为68%和65%。

结论

尽管血小板参数对重症CAP患儿细菌和病毒感染的诊断价值有限,但仍有望与其他指标结合,为及时治疗提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01d3/10839274/8a8c9b454264/tp-13-01-52-f1.jpg

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