中性粒细胞碱性磷酸酶活性在儿童长期发热鉴别诊断中的意义

The Significance of Neutrophil Alkaline Phosphatase Activity in Differential Diagnosis for the Fever of Unknown Origin of Children

目的:探讨中性粒细胞碱性磷酸酶(NAP)活性在儿童长期发热鉴别诊断中的意义。方法:以偶氮偶联磷酸奈酚AS-BI法测定63例发热患儿及50例健康儿童外周血中性粒细胞碱性磷酸酶活性,以阳性率和阳性指数表示。结果:NAP阳性率在发热组为71.3%±24.1%,对照组为74.6%±11.7%,两组比较无显著性差异。阳性指数发热组为138.7±78.6,对照组为95.3±26.5,两组比较有非常显著性差异。NAP阳性率及阳性指数在细菌感染组为87.6%±12.9%和196.0±76.3,均明显高于病毒感染组(48.7%±21.8%和69.9±39.3)和对照组,在病毒感染组则明显低于对照组、支原体感染组及结缔组织病组。结论:NAP活性在长期发热性疾病的鉴别诊断中,尤其在鉴别细菌与病毒感染中有重要参考意义。在阳性率和阳性指数两个指标中,阳性指数更能反映NAP活性。

To explore the significance of the neutrophil alkaline phosphatase (NAP) in differential diagnosis for the fever of unknown origin (FUO) of children. Methods: The NAP activities determined by Naphthol AS-BI phosphate of 63 FUO children (FUO group)and 50 healthy children(control group) were expressed by the positive rate and the positive score. Results:There was no significant difference in the positive rates between the FUO group(71.3% ±4.1%)and the control group(74.6%±11.7%). There was a very significant difference in the positive scores between the FUO group (138.7±78.6) and the control group(95.3± 26.5) (P< 0.01). In the FUO group,the NAP positive rate and score in bacterial infection group(87.6% ±12.9% and 196.0 ± 76.3)were much higher than those in viral infection group(48.7% ±21.8% and 69.9±39.3)(P<0.01).Conclusion:The NAP activity is of important significance in differential diagnosis for FUO children;especially in identifying bacterial infection or viral infection.Compared with the positive rate,the positive score is more important.