He Xiang, Zou Yingbo, Li Yunrong, Fu Chao, Li Chengcheng, Zhou Xiaolan, Huang Bo
Pediatric Intensive Care Unit, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, Guizhou, China.
Br J Hosp Med (Lond). 2025 Sep 25;86(9):1-20. doi: 10.12968/hmed.2025.0173. Epub 2025 Sep 24.
With the increasing incidence of severe pneumonia in children, timely and accurate diagnosis and treatment are essential for improving prognosis. In recent years, heparin-binding protein (HBP) and procalcitonin (PCT) have gained attention as inflammatory biomarkers in clinical settings. However, their precise roles in the diagnosis and treatment of severe pediatric pneumonia remain unclear. This study aimed to evaluate the clinical value of combining HBP and PCT in diagnosing severe pneumonia in children and assessing the efficacy of antibiotic therapy. Data were collected from 189 pediatric patients hospitalized with pneumonia in the Pediatric Intensive Care Unit, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University) between May 2022 and August 2023. Serum HBP and PCT levels were measured using fluorescence immunochromatography. Spearman and Pearson correlation analyses, along with logistic regression, were performed to identify influencing factors and evaluate diagnostic performance. Receiver operating characteristic (ROC) curves were plotted to assess diagnostic accuracy. HBP and PCT levels were significantly elevated in the severe pneumonia group compared to the mild pneumonia group ( < 0.05). Multivariate logistic regression analysis showed that HBP and PCT were independent risk factors for severe pneumonia ( < 0.05). ROC curve analysis demonstrated that the combined use of HBP, PCT, age, and body mass index (BMI) improved diagnostic accuracy, with the highest area under the curve (AUC) observed for the combination of PCT + HBP + BMI + Age (AUC = 0.922; 95% CI: 0.879-0.965; < 0.001). Additionally, HBP and PCT levels were significantly higher in the severe bacterial infection group than in the severe non-bacterial infection group ( < 0.05). Multivariate logistic regression identified HBP as an independent risk factor for severe bacterial pneumonia in children ( < 0.001). ROC analysis showed that HBP had a high predictive value for severe bacterial pneumonia, with an AUC of 0.884 (95% CI: 0.766-0.921; < 0.001). Dynamic changes in HBP and PCT levels reflected the efficacy of antibiotic treatment. HBP and PCT are valuable for early diagnosis and antibiotic assessment in children with severe pneumonia.
随着儿童重症肺炎发病率的不断上升，及时、准确的诊断和治疗对于改善预后至关重要。近年来，肝素结合蛋白（HBP）和降钙素原（PCT）作为临床环境中的炎症生物标志物受到关注。然而，它们在儿童重症肺炎诊断和治疗中的确切作用仍不明确。本研究旨在评估联合HBP和PCT诊断儿童重症肺炎及评估抗生素治疗疗效的临床价值。收集了2022年5月至2023年8月期间在遵义市第一人民医院（遵义医科大学第三附属医院）儿科重症监护病房住院的189例肺炎患儿的数据。采用荧光免疫层析法检测血清HBP和PCT水平。进行Spearman和Pearson相关性分析以及逻辑回归分析，以确定影响因素并评估诊断性能。绘制受试者工作特征（ROC）曲线以评估诊断准确性。与轻症肺炎组相比，重症肺炎组的HBP和PCT水平显著升高（<0.05）。多因素逻辑回归分析表明，HBP和PCT是重症肺炎的独立危险因素（<0.05）。ROC曲线分析表明，联合使用HBP、PCT、年龄和体重指数（BMI）可提高诊断准确性，其中PCT+HBP+BMI+年龄组合的曲线下面积（AUC）最高（AUC = 0.922；95%CI：0.879 - 0.965；<0.001）。此外，重症细菌感染组的HBP和PCT水平显著高于重症非细菌感染组（<0.05）。多因素逻辑回归确定HBP是儿童重症细菌性肺炎的独立危险因素（<0.001）。ROC分析表明，HBP对重症细菌性肺炎具有较高的预测价值，AUC为0.884（95%CI：0.766 - 0.921；<0.001）。HBP和PCT水平的动态变化反映了抗生素治疗的疗效。HBP和PCT对儿童重症肺炎的早期诊断和抗生素评估具有重要价值。
