摘要
目的探究新型指标HROX指数在儿童重症肺炎早期诊治中的应用价值。方法回顾性收集2020年2月至2022年12月苏州市吴江区儿童医院收治的198例肺炎患儿的临床资料,其中重症肺炎(重症肺炎组)98例,普通肺炎(普通肺炎组)100例。比较两组一般临床资料、实验室指标、影像学指标及HROX指数[HROX指数=心率×呼吸频率/血氧饱和度(SpO_(2))]。分析HROX指数对早期诊断儿童重症肺炎的效能及预测患儿住院期间需接受氧疗的效能。结果与普通肺炎组相比,重症肺炎组气急、喘息、吸气性三凹征及胸腔积液发生率更高,住院时间更长,C-反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、乳酸脱氢酶(LDH)、D-二聚体、HROX指数水平更高,中性粒细胞百分比(NEU)、血红蛋白(Hb)水平更低,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,较高的HROX指数[OR(95%CI)=1.211(1.038~1.414)]以及PCT[OR(95%CI)=1.570(1.142~2.157)]、IL-6[OR(95%CI)=1.028(1.001~1.057)]、D-二聚体[OR(95%CI)=18.697(1.091~320.405)]水平是促进重症肺炎发生的独立危险因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,HROX指数有助于早期诊断重症肺炎[AUC(95%CI)=0.907(0.863~0.951),P<0.001],且能预测患儿住院期间需接受氧疗的情况[AUC(95%CI)=0.902(0.857~0.947),P=0.003]。结论HROX指数有助于临床医师早期诊断重症肺炎,并可预测患儿住院期间需接受氧疗的情况。
Objective To explore the application value of a novel indicator of HROX index in early diagnosis and treatment of severe pneumonia in children.Methods The clinical data of 198 pediatric patients with pneumonia who were admitted to Suzhou Wujiang District Children′s Hospital from February 2020 to December 2022 were retro-spectively collected,including 98 cases of severe pneumonia(severe pneumonia group)and 100 cases of common pneu-monia(common pneumonia group).The general clinical data,laboratory indicators,imaging indicators and HROX index[HROX index=heart rate×respiratory rate/oxygen saturation(SpO_(2))]were compared between the two groups.The efficacy of HROX index in early diagnosis of severe pneumonia in children and in predicting the need for oxygen therapy in pediatric patients during hospitalization was analyzed.Results Compared with the common pneumonia group,the severe pneumonia group had higher incidence rates of shortness of breath,wheezing,inspiratory three-concave sign and pleural effusion,and longer hospital stay,higher levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),lactate dehydrogenase(LDH),D-dimer and HROX index,and lower levels of neutrophil percentage(NEU)and hemo-globin(Hb),and the differences were statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that higher HROX index[OR(95%CI)=1.211(1.038-1.414)]and PCT[OR(95%CI)=1.570(1.142-)],IL-6[OR(95%CI)=1.028(1.001-1.057)]and D-dimer[OR(95%CI)=18.697(1.091-320.405)]levels were independent risk factors for promoting the occurrence of severe pneumonia(P<0.05).The results of receiver operating characteristic(ROC)curve analysis showed that HROX index was helpful for early diagnosis of severe pneu-monia[AUC(95%CI)=0.907(0.863-0.951),P<0.001],and could predict the need for oxygen therapy during hospitalization in the pediatric patients[AUC(95%CI)=0.902(0.857-0.947),P=0.003].Conclusion HROX index helps clinicians diagnose severe pneumonia early and predicts the need for oxygen therapy during hospitalization in pediatric patients.
作者
严秋丽
张方园
陈颖青
施金金
钮文思
YAN Qiuli;ZHANG Fangyuan;CHEN Yingqing;SHI Jinjin;NIU Wensi(Department of Pediatric Internal Medicine,Suzhou Wujiang District Children′s Hospital,Jiangsu 215200,China)
出处
《中国临床新医学》
2024年第8期881-885,共5页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
江苏省苏州市卫生青年骨干人才“全国导师制”培训项目(编号:Qngg2023059)
苏州市医学重点扶持学科项目(编号:SZFCXK202134)
苏州市吴江区“科教兴卫”项目(编号:WWK202111)。
关键词
儿童
重症肺炎
血氧饱和度
新型指标
早期诊断
氧疗
Children
Severe pneumonia
Oxygen saturation
Novel indicator
Early diagnosis
Oxygen therapy
