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目的 探究肺部超声联合血清白细胞介素6(IL-6)、白细胞介素17(IL-17)、D-二聚体水平在新生儿肺炎中的诊断价值。方法 选取2022年3月至2023年8月石家庄市人民医院收治的102例疑似新生儿肺炎患儿为研究对象，根据临床表现、实验室检验、胸部X线片(金标准)将细菌性肺炎患儿分为肺炎组(62例),其余分为非肺炎组(40例)。比较两组血清IL-6、IL-17、D-二聚体水平；ROC曲线分析血清IL-6、IL-17、D-二聚体对新生儿肺炎的诊断效能；采用Kappa检验分析肺部超声联合血清IL-6、IL-17、D-二聚体诊断新生儿肺炎的一致性；四格表法分析肺部超声联合血清IL-6、IL-17、D-二聚体对新生儿肺炎的诊断效能。结果 与其他疾病组相比，肺炎组患儿血清IL-6、IL-17、D-二聚体水平均明显升高(P<0.05);血清IL-6诊断新生儿肺炎的曲线下面积(AUC)为0.871,最佳截断值为152.62 pg/mL;血清IL-17诊断新生儿肺炎的AUC为0.898,最佳截断值为13.25 ng/L肺部超声检查出肺炎43例，非肺炎59例，与金标准具有一致性(Kappa值=0.564,P<0.001);血清IL-6、IL-17、D-二聚体检查结果分别与金标准具有一致性(Kappa值=0.589、0.630、0.632,P均<0.001);四者联合检测与金标准具有较高一致性(Kappa值=0.744,P<0.001);四者联合诊断的敏感度显著高于IL-6、IL-17、D-二聚体及肺部超声单独诊断(P<0.05),特异度显著低于肺部超声单独诊断(P<0.05),准确率显著高于肺部超声单独诊断(P<0.05)。结论 新生儿肺炎患儿血清IL-6、IL-17、D-二聚体水平均上调，肺部超声联合血清IL-6、IL-17、D-二聚体诊断新生儿肺炎具有更高的诊断效能。
Abstract：Objective To investigate the diagnostic value of pulmonary ultrasound combined with serum levels of interleukin-6(IL-6),interleukin-17(IL-17),and D-dimer for neonatal pneumonia.Methods From March 2022 to August 2023,102 confirmed cases of suspected neonatal pneumonia treated in Shijiazhuang People's Hospital were regarded as the research subjects.According to the clinical manifestations, laboratory tests, and chest X-ray(gold standard),children with bacterial pneumonia were divided into pneumonia group(62 cases),and the rest were divided into non-pneumonia group(40 cases).The levels of serum IL-6,IL-17,and D-dimer were compared between two groups; ROC curve was applied to analyze the diagnostic efficacy of serum IL-6,IL-17,and D-dimer for neonatal pneumonia; Using Kappa test to analyze the consistency of pulmonary ultrasound combined with serum IL-6,IL-17,and D-dimer in the diagnosis of neonatal pneumonia; Four grid table method was applied to analyze the diagnostic efficacy of pulmonary ultrasound combined with serum IL-6,IL-17,and D-dimer for neonatal pneumonia.Results Compared with other disease group, the serum levels of IL-6,IL-17,and D-dimer in the pneumonia group were obviously increased(P<0.05);The area under the curve(AUC) of serum IL-6 in the diagnosis of neonatal pneumonia was 0.871,and the optimal cut-off value was 152.62 pg/mL,and the AUC of serum IL-17 in the diagnosis of neonatal pneumonia was 0.898,and the optimal cut-off value was 13.25 ng/L;pulmonary ultrasound examination revealed 43 cases of pneumonia and 59 cases of non pneumonia, which were consistent with the gold standard(Kappa value=0.564,P<0.001);the results of serum IL-6,IL-17,and D-dimer tests were consistent with the gold standard(Kappa values=0.589,0.630,0.632,P<0.001);the combination of the four methods showed high consistency with the gold standard(Kappa value=0.744,P<0.001);the sensitivity of the combined diagnosis of the four was obviously higher than that of IL-6,IL-17,D-dimer, and pulmonary ultrasound alone(P<0.05),the specificity was obviously lower than that of pulmonary ultrasound alone(P<0.05),and the accuracy was obviously higher than that of pulmonary ultrasound alone(P<0.05).Conclusion The serum levels of IL-6,IL-17,and D-dimer are all up-regulated in children with neonatal pneumonia.Pulmonary ultrasound combined with serum IL-6,IL-17,and D-dimer has higher diagnostic efficacy in diagnosing neonatal pneumonia.
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基本信息:
中图分类号:R722.135
引用信息:
[1]王妍,雷燕,张亚宇,等.肺部超声联合血清IL-6、IL-17、D-二聚体在新生儿肺炎诊断中的价值研究[J].中国实验诊断学,2026,30(01):30-35.
基金信息:
河北省2024年度医学科学研究课题计划(编号：20240862)
2026-01-25
2026-01-25