床旁超声联合sTREM-1、sIL-2R在新生儿肺炎早期诊断中的应用效果

Application Effect of Bedside Ultrasound Combined with sTREM-1 and sIL-2R in the Early Diagnosis of Neonatal Pneumonia

摘要: 目的：探究床旁超声联合可溶性髓系细胞触发受体-1 (sTREM-1)、可溶性白细胞介素-2受体(sIL-2R)在新生儿肺炎早期诊断中的应用价值。方法：选取2019年1月~2021年6月本院接收的新生儿肺炎的患儿120例，依据X线诊断结果分为轻症肺炎组(n = 75)和重症肺炎组(n = 45)，选取同期在本院分娩的健康新生儿50例为对照组，以X线诊断为金标准，三组均行床旁肺部超声检查及病原学检测，分析超声诊断结果，根据病原学检测结果分为细菌性肺炎组(n = 65)和非细菌性肺炎组(n = 55)。应用双抗体夹心酶联免疫吸附法(DAS-ELISA)检测三组sTREM-1、sIL-2R水平，应用受试者工作特征(ROC)曲线分析血清sTREM-1、sIL-2R在新生儿肺炎早期诊断中的应用价值。结果：床旁肺部超声检出新生儿肺炎115例，诊断准确率为95.83%；细菌性肺炎组与非细菌性肺炎组sTREM-1、sIL-2R水平明显高于对照组(P < 0.05)，细菌性肺炎组sTREM-1水平明显高于非细菌性肺炎组，sIL-2R水平明显低于非细菌性肺炎组(P < 0.05)；重症与轻症肺炎组sTREM-1、sIL-2R水平明显高于对照组(P < 0.05)，重症肺炎组sTREM-1、sIL-2R水平明显高于轻症肺炎组(P < 0.05)；sTREM-1、sIL-2R及联合检测评估新生儿肺炎为细菌性肺炎的AUC分别为0.739、0.706、0.797，评估新生儿肺炎为重症肺炎的AUC分别为0.739、0.706、0.797 (P < 0.05)。结论：床旁肺部超声检查具较高诊断准确率，具明显超声图像特点，sTREM-1、sIL-2R可有效诊断新生儿肺炎，其中sTREM-1可为细菌性新生儿肺炎重要诊断指标。

Abstract: Objective: To explore the application value of bedside ultrasound combined with soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) and soluble interleukin-2 receptor (sIL-2R) in the early diagnosis of neonatal pneumonia. Methods: A total of 120 neonates with pneumonia admitted to the hospital were enrolled between January 2019 and June 2021. According to diagnosis results of X-ray, they were divided into mild pneumonia group (n = 75) and severe pneumonia group (n = 45). A total of 50 healthy neonates during the same period were enrolled as control group. Taking X-ray diagnosis as the golden standard, neonates in the three groups underwent bedside lung ultrasound examination and etiology detection. The diagnosis results of ultrasound were analyzed. According to results of etiology detection, they were divided into bacterial pneumonia group (n = 65) and non-bacterial pneumonia group (n = 55). The levels of sTREM-1 and sIL-2R in the three groups were detected by double antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA). And their application value in the early diagnosis of neonatal pneumonia was analyzed by receiver operating characteristic (ROC) curves. Results: Bedside lung ultrasound showed that there were 115 neonates with pneumonia, with diagnostic accuracy rate of 95.83%. The levels of sTREM-1 and sIL-2R in bacterial pneumonia group and non-bacterial pneumonia group were significantly higher than those in control group (P < 0.05). The level of sTREM-1 in bacterial pneumonia group was significantly higher than that in non-bacterial pneumonia group, while sIL-2R level was significantly lower than that in non-bacterial pneumonia group (P < 0.05). The levels of sTREM-1 and sIL-2R in severe pneumonia group and mild pneumonia group were significantly higher than those in control group (P < 0.05), which were significantly higher in severe pneumonia group than mild pneumonia group (P < 0.05). AUC values of sTREM-1, sIL-2R and combined detection for evaluating bacterial pneumonia and severe pneumonia were (0.739, 0.706, 0.797), and (0.739, 0.706, 0.797), respectively (P < 0.05). Conclusion: Bedside lung ultrasound has high diagnostic accuracy rate and obvious ultrasound images characteristics. The sTREM-1 and sIL-2R can effectively diagnose neonatal pneumonia. The sTREM-1 can be applied as an important diagnostic index of neonatal bacterial pneumonia.