关键词: 小儿支气管炎, 降钙素原, C反应蛋白, 白介素-8, 激素干预

Abstract:

Objective To explore the value of the combination of procalcitonin(PCT), C-reactive protein(CRP) and interleukin-8 (IL-8) to predict the effect of hormonal intervention(HI) in children with bronchitis.Methods Totally 100 children with bronchitis admitted to our hospital from January 2016 to January 2020 were included, all patients were treated with the intervention of correcting electrolyte acid-base balance, eliminating phlegm, anti-infection; in the meantime, the patients were given oxygen inhalation therapy using budesonide (diluted with 0.9% sodium chloride ) at 1 ml/kg^-1, twice per day (10 min once). After 1-week treatment, the short-term efficacy was evaluated based on the criteria for pediatric bronchitis of children in ' Modern Applied Pediatrics'. Blood samples were collected before treatment, the general data was compared between groups and serum indexes (PCT, CRP and IL-8) were determined; the receiver operating characteristic curve(ROC) was drawn to analyze the predictive value of the indicators for the effect of HI. Kappa test was used to analyze the consistency between the combination and clinical evaluation. Results After intervention, there were 22 (22.00%) for unsuccessful,45 (45.00%) for certain effect, 33 (33.00%) for significantly effect. The levels of serum PCT, CRP and IL -8 in effective group were significantly lower than those in ineffective group (P<0.05).The AUC of serum PCT, CRP and IL-8 was 0.715, 0.758 and 0.747, respectively. When PCT> was 4.420 μg/L, CRP>16.945 mg/L, and IL-8>14.840 ng/L, the risk of ineffective HI was increased. The AUC of the three joint prediction was 0.858, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the three joint prediction were 89.74%, 63.63%, 84.00%, 89.74% and 63.64%, respectively. the consistency between the three joint prediction and clinical evaluation was 0.534 by Kappa test (general consistency).Conclusion For children with bronchitis, the combination of PCT, CRP and IL-8 in predicting the efficacy of HI has high value, and the consistent is closer with clinical evaluation, it should be paid attention.

Key words: bronchitis in children, procalcitonin, C-reactive protein, interleukin -8, hormone intervention