Predictive Value Analysis of the Expression of Serum GDF-15 and Neutrophil Surface CD64 on Myocardial Damage in Children with Pneumonia

Abstract

Background: Myocardial damage is a severe complication of pneumonia in children. Early diagnosis and symptomatic intervention can improve the prognosis of affected children. This study aims to investigate the predictive value of serum growth differentiation factor-15 (GDF-15) and neutrophil cluster of differentiated lymphoid cells 64 (CD64) surface expressions in identifying myocardial damage in children with pneumonia. Methods: A total of 177 children with pneumonia admitted to the Shandong Provincial Third Hospital from January 2019 to January 2021 were selected as the study subjects. The children were divided into two groups: the control group (CG) consisted of 91 children with simple pneumonia, and the study group (SG) consisted of 86 children with pneumonia complicated with myocardial damage. This study measured the levels of serum GDF-15 and cardiac troponin I (cTnI, a cardiac damage marker) using enzyme-linked immunosorbent assay and the expression of neutrophil surface CD64 by flow cytometry. The relationship among GDF-15, CD64 and cTnI was analyzed using the Pearson method. The diagnostic value of GDF-15 and CD64 expression on myocardial damage was analyzed by drawing the receiver operating characteristic (ROC) curve. Results: Compared to the CG, the SG had significantly higher values for heat duration, peak heat, chest X-ray results, hospitalization time, course of disease, serum cTnI, GDF-15, CD64, erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), C-reactive protein (CRP), and red blood cell distribution width (RDW) (p < 0.05). Correlation analysis showed that serum GDF-15 and CD64 were positively correlated with cTnI in children with pneumonia and myocardial damage (p < 0.05). Taking the presence or absence of myocardial damage in all children as the dependent variable, and serum levels of GDF-15 and CD64 as independent variables, regression analysis revealed that heat duration >5 d, course of disease, serum GDF-15 and CD64 were independent influencing factors of myocardial damage in children with pneumonia (p < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the course of disease, serum GDF-15 and CD64 had clinical value in predicting myocardial damage, and combined detection of serum GDF-15 and CD64 had a higher diagnostic value for myocardial damage (p < 0.05). Conclusions: The serum levels of GDF-15 and CD64 in children with pneumonia are positively correlated with cTnI protein level, which effectively predicts the occurrence of myocardial damage. Their combination detection has clinical reference value for the diagnosis of pneumonia combined with myocardial damage in children.