Clinical Values of Combined Heparin-Binding Protein and Procalcitonin Testing in the Diagnosis and Management of Severe Pneumonia in Children.

Abstract

Aims/Background 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. Methods 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. Results HBP and PCT levels were significantly elevated in the severe pneumonia group compared to the mild pneumonia group (p < 0.05). Multivariate logistic regression analysis showed that HBP and PCT were independent risk factors for severe pneumonia (p < 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; p < 0.001). Additionally, HBP and PCT levels were significantly higher in the severe bacterial infection group than in the severe non-bacterial infection group (p < 0.05). Multivariate logistic regression identified HBP as an independent risk factor for severe bacterial pneumonia in children (p < 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; p < 0.001). Dynamic changes in HBP and PCT levels reflected the efficacy of antibiotic treatment. Conclusion HBP and PCT are valuable for early diagnosis and antibiotic assessment in children with severe pneumonia.