肺部超声在监测儿科患者 SARS-CoV-2 后肺炎和炎症生物标志物方面的功效

Q4 Medicine
Medicina Pub Date : 2024-08-11 DOI:10.3390/medicina60081296
Ramona Chelcea, Mihaela Dediu, Diana Dabica, Sorina Maria Denisa Laitin, Ioana Mihaiela Ciuca
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引用次数: 0

摘要

背景和目的:鉴于我们对 SARS-CoV-2 感染后小儿肺炎的认识存在重大差距,本研究旨在评估小儿肺炎超声评分(PedPne)与炎症生物标志物之间的关系。本研究的主要目的是评估 PedPne 与炎症生物标志物(IL-6 和 dNLR)相比,对感染 SARS-CoV-2 后儿科患者发生肺炎的预测价值。材料和方法:这项纵向观察研究收集了急性 SARS-CoV2 感染后确诊为肺炎的儿科患者的数据。研究重点分析了从最初入院到 7 天随访期间 PedPne 评分以及 IL-6 和 dNLR 等炎症标志物的变化。统计分析包括计算每种生物标志物的灵敏度、特异性和曲线下面积(AUC),并通过回归分析确定它们预测肺炎发生的危险比。结果分析发现,dNLR 的重要临界值为 1.88(灵敏度为 77.0%,特异度为 85.7%,AUC 为 0.802,p < 0.001),IL-6 为 6.1 pg/mL(灵敏度为 70.3%,特异度为 92.9%,AUC 为 0.869,p < 0.001),PedPne 评分为 3.3(灵敏度为 75.7%,特异度为 78.6%,AUC 为 0.794,p < 0.001)。相反,NLR 的诊断率较低(AUC 0.485,p = 0.327)。回归分析进一步凸显了这些标记物的强大预测能力,IL-6 显示肺炎风险增加了四倍(HR = 4.25,CI:2.07-9.53,p < 0.001),dNLR 显示增加了两倍多(HR = 2.53,CI:1.19-6.97,p = 0.006),PedPne 评分与风险增加一倍多相关(HR = 2.60,CI:1.33-5.18,p < 0.001)。结论该研究最终证明,PedPne 超声波评分和特定的炎症生物标志物(如 dNLR 和 IL-6)都是 COVID-19 感染后儿科患者发生肺炎的重要预测指标。这些研究结果主张将这些生物标志物纳入常规临床评估,以提高诊断准确性,并加强对感染 SARS-CoV-2 后儿童肺炎的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lung Ultrasound Efficacy in Monitoring Post-SARS-CoV-2 Pneumonia and Inflammatory Biomarkers in Pediatric Patients
Background and Objectives: Recognizing the crucial gaps in our understanding of pediatric pneumonia post-SARS-CoV-2 infection, this study aimed to assess the relationship between Pediatric Pneumonia Ultrasound Scores (PedPne) and inflammatory biomarkers. The primary objective of this study is to evaluate the predictive value of PedPne in comparison with inflammatory biomarkers (IL-6 and dNLR) for the development of pneumonia in pediatric patients following SARS-CoV-2 infection. Materials and Methods: This longitudinal observational study collected data from pediatric patients diagnosed with pneumonia after an acute SARS-CoV2 infection. The study focused on analyzing changes in PedPne scores and inflammatory markers such as IL-6 and dNLR from initial admission to follow-up at 7 days. Statistical analysis involved calculating the sensitivity, specificity, and Area Under the Curve (AUC) for each biomarker, alongside regression analysis to determine their hazard ratios for predicting pneumonia development. Results: The analysis identified significant cutoff values for dNLR at 1.88 (sensitivity 77.0%, specificity 85.7%, AUC 0.802, p < 0.001), IL-6 at 6.1 pg/mL (sensitivity 70.3%, specificity 92.9%, AUC 0.869, p < 0.001), and PedPne score at 3.3 (sensitivity 75.7%, specificity 78.6%, AUC 0.794, p < 0.001). Conversely, NLR showed lower diagnostic performance (AUC 0.485, p = 0.327). Regression analysis further highlighted the strong predictive power of these markers, with IL-6 showing a fourfold increase in pneumonia risk (HR = 4.25, CI: 2.07–9.53, p < 0.001), dNLR indicating more than a twofold increase (HR = 2.53, CI: 1.19–6.97, p = 0.006), and PedPne score associated with more than a doubling of the risk (HR = 2.60, CI: 1.33–5.18, p < 0.001). Conclusions: The study conclusively demonstrated that both PedPne ultrasound scores and specific inflammatory biomarkers such as dNLR and IL-6 are significant predictors of pneumonia development in pediatric patients post-COVID-19 infection. These findings advocate for the integration of these biomarkers in routine clinical assessments to enhance the diagnostic accuracy and management of pneumonia in children following SARS-CoV-2 infection.
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来源期刊
Medicina
Medicina Medicine-Medicine (all)
CiteScore
0.10
自引率
0.00%
发文量
66
审稿时长
24 weeks
期刊介绍: Publicada con el apoyo del Ministerio de Ciencia, Tecnología e Innovación Productiva. Medicina no tiene propósitos comerciales. El objeto de su creación ha sido propender al adelanto de la medicina argentina. Los beneficios que pudieran obtenerse serán aplicados exclusivamente a ese fin.
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