Values of D-dimer, prealbumin and soluble triggering receptor expressed on myeloid cells-1 in diagnosing severe pneumonia in children

Objective To analyze the value of combined detection of serum D-dimer (D-D), prealbumin (PA) and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in diagnosing severe pneumonia in children.

Methods A total of 70 hospitalized children with pneumonia were divided into severe pneumonia group and common pneumonia group according to severity of disease, with 35 cases in each group; the severe pneumonia group was divided into survival subgroup with 30 cases and death subgroup with 5 cases according to the prognosis during hospitalization. Enzyme-linked immunosorbent assay (ELISA) was used to detect the level of sTREM-1, and immunoturbidimetry was used to detect the levels of serum D-D and PA; the receiver operating characteristic (ROC) curve was used to analyze the value of combined detection of serum D-D, PA and sTREM-1 in diagnosing severe pneumonia in children; the Logistic regression model was used to analyze the effects of serum D-D, PA and sTREM-1 on the occurrence of severe pneumonia.

Results The levels of serum D-D and sTREM-1 at hospital admission in the common pneumonia group were significantly lower than those in the severe pneumonia group, while the level of serum PA was significantly higher than that in the severe pneumonia group (P < 0.05). Values of the area under the curve (AUC) of serum D-D, PA, sTREM-1 and their combined detection for diagnosis of severe pneumonia in children were 0.849, 0.858, 0.833 and 0.986 respectively. After treatment in hospital, the levels of D-D and sTREM-1 in the survival subgroup significantly gradually decreased, while the level of serum PA significantly gradually increased (P < 0.01); the levels of D-D and sTREM-1 in the death subgroup gradually increased after treatment in hospital, while the level of serum PA gradually decreased (P < 0.01). At the time points of hospital admission, 3 days after admission and 1 week after admission, the serum D-D and sTREM-1 levels in the death subgroup were significantly higher than those in the survival subgroup, while the serum PA levels were significantly lower than that in the survival subgroup (P < 0.01). The increased sTREM-1 was an independent risk factor for occurrence of severe pneumonia (P < 0.05).

Conclusion In the children with severe pneumonia, the levels of serum D-D and sTREM-1 increase, while the level of PA decreases, and the combined detection of the three indicators can not only increase the early diagnosis rate of severe pneumonia, but also guide the efficacy evaluation.