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社区获得性肺炎合并川崎病患儿临床指标的预测价值

Predictive value of clinical indicators in children with community-acquired pneumonia complicated with Kawasaki disease.

作者信息

Duan Yuanhui, Ou Yuexu, Gan Xiaoming, Li Jieling, Cao Jie

机构信息

Department of Medical General Ward Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China.

Department of Medical General Ward Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China.

出版信息

J Pediatr (Rio J). 2025 Aug 12;101(5):101424. doi: 10.1016/j.jped.2025.101424.

Abstract

OBJECTIVE

This study aimed to investigate the predictive value of clinical indicators in community-acquired pneumonia (CAP) complicated with Kawasaki disease (KD).

METHODS

A retrospective analysis was conducted on the clinical data of inpatients with KD (39 cases), CAP (40 cases), and CAP complicated with KD (CAPKD, 32 cases) at the Children's Hospital of Chongqing Medical University from February 2021 to October 2022. The clinical indicators examined included serum cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, TNF-α, IFN-γ), White Blood Cell (WBC), Neutrophilic granulocyte percentage(NEU%), blood platelet(PLT), Red Blood Cell (RBC), Hemoglobin(Hb), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), procalcitonin(PCT), alanine aminotransferase(ALT), alkaline phosphatase(ALP), Gamma-glutamyl transferase (γ-GT), Aspartate aminotransferase (AST), albumin(Alb), Lactate dehydrogenase (LDH), globulin(Glb), and Total Protein(TP) in patients with KD, CAP, and CAPKD were compared.

RESULTS

The present findings showed that IL-6 > 55.4pg/mL, IL-10 > 9.15pg/mL, PCT > 0.19ng/mL, and ALT > 22.5 U/L were important predictors of CAPKD. Additionally, Hb > 103.5 g /L, and TP > 63.85 g/L have predictive values for CAP without KD. The authors also observed a positive correlation between PCT and IL-6, IL-10. However, Hb and TP were negatively correlated with IL-6 and IL-10.

CONCLUSION

From the perspective of cytokine levels, IL-6 > 55.4 pg/mL and IL-10 > 9.15 pg/mL have important predictive values for CAPKD.

摘要

目的

本研究旨在探讨临床指标对社区获得性肺炎(CAP)合并川崎病(KD)的预测价值。

方法

对重庆医科大学附属儿童医院2021年2月至2022年10月收治的KD患者(39例)、CAP患者(40例)及CAP合并KD患者(CAPKD,32例)的临床资料进行回顾性分析。检测的临床指标包括血清细胞因子(IL-2、IL-4、IL-6、IL-10、IL-17A、TNF-α、IFN-γ)、白细胞(WBC)、中性粒细胞百分比(NEU%)、血小板(PLT)、红细胞(RBC)、血红蛋白(Hb)、红细胞沉降率(ESR)、C反应蛋白(CRP)、降钙素原(PCT)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(γ-GT)、天冬氨酸氨基转移酶(AST)、白蛋白(Alb)、乳酸脱氢酶(LDH)、球蛋白(Glb)和总蛋白(TP),并对KD、CAP及CAPKD患者的上述指标进行比较。

结果

本研究结果显示,IL-6>55.4pg/mL、IL-10>9.15pg/mL、PCT>0.19ng/mL及ALT>22.5 U/L是CAPKD的重要预测指标。此外,Hb>103.5 g /L及TP>63.85 g/L对无KD的CAP具有预测价值。作者还观察到PCT与IL-6、IL-10呈正相关。然而,Hb和TP与IL-6和IL-10呈负相关。

结论

从细胞因子水平来看,IL-6>55.4 pg/mL和IL-10>9.15 pg/mL对CAPKD具有重要的预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f64/12361764/db25fb09f92e/gr1.jpg

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