血清淀粉样蛋白A和C-反应蛋白在小儿感染性疾病早期诊断中的价值

Values of SAA and CRP in early diagnosis of pediatric infectious diseases

目的探讨血清淀粉样蛋白A(SAA)、C-反应蛋白(CRP)在小儿感染性疾病早期诊断中的临床价值。方法采用酶联免疫吸附试验(ELISA)检测120例病毒感染患儿(病毒组)、60例细菌感染患儿(细菌组)及40例健康儿童(健康组)血清SAA、CRP水平,并以临床及实验室确诊结果作为金标准,进行诊断学效能评价。结果病毒组、细菌组及健康组的SAA、CRP、SAA/CRP测定值差异均具有统计学意义(P<0.05);病毒组的SAA水平为(137.8±57.6)mg/L、SAA/CRP为17.67±3.06,均明显高于健康组(P<0.05)。细菌组患儿的SAA、CRP、SAA/CRP测定值均明显高于健康组(P<0.05)。SAA/CRP测定值诊断病毒感染的ROC曲线下面积(AUC)为0.933,灵敏度为0.902、特异度为0.957。SAA/CRP测定值诊断细菌感染的ROC曲线下面积为0.901,灵敏度为0.894、特异度为0.921。结论对于细菌感染,SAA、CRP检测均具有较好的诊断效能,病毒感染需要联合SAA、CRP检测并计算SAA/CRP值进行鉴别诊断具有较高的诊断价值。

Objective To study the clinical values of serum amyloid A（SAA）and C reactive protein（CRP）in the early diagnosis of pediatric infectious diseases.Methods The ELISA method was used to detect serum SAA and CRP levels in 120 children patients with viral infection（virus group）,60 children patients with bacterial infection（bacterial group）and 40 healthy children（healthy group）.The diagnostic efficiency of these two indicators was evaluated with the clinical and laboratory definite diagnosis as the golden standard.Results The SAA,CRP and SAA/CRP determination values had the statistical difference among the viral group,bacterial group and the healthy group（P〈0.05）;SAA in the viral group was（137.8±57.6）mg/L,SAA/CRP was 17.67±3.06,which were significantly higher than those in the healthy group（P〈0.05）.The values of SAA,CRP and SAA/CRP in the bacterial group were higher than those in the healthy group（P〈0.05）.The area under the curve（AUC）of receiver operating characteristic（ROC）in the SAA/CRP value for diagnosing viral infection was 0.933,the sensitivity was 0.902 and the specificity was 0.957.AUC of ROC in the SAA/CRP value for diagnosing bacterial infection was 0.901,the sensitivity was 0.894 and the specificity was 0.921.Conclusion For diagnosing bacterial infection,the SAA and CRP detections all have better diagnostic efficiency,diagnosing viral infection needs to detect SAA combined with CRP and calculate the SAA/CRP value for conduct the differentiation diagnosis,which has higher diagnostic value.