血清淀粉样蛋白A、C反应蛋白和血常规检测在儿童呼吸道感染早期诊断中的应用价值

Application value of serum amyloid A,C-reactive protein,and blood routine detection in early diagnosis of respiratory infection in children

目的 探讨血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)和血常规检测在儿童呼吸道感染早期诊断中的应用价值。方法 选取本院儿科2017年7月至2018年6月收治的呼吸道感染儿童作为研究对象(共186例),其中细菌感染者96例(细菌感染组),病毒感染者90例(病毒感染组),并选取同期体检健康儿童100例作为对照(健康对照组),检测所有研究对象SAA、CRP和血常规中白细胞计数(WBC)水平,分析其在儿童呼吸道感染早期诊断和鉴别诊断中的效能。结果 健康对照组SAA、CRP和WBC水平分别为(4.96±1.02)mg/L、(3.52±1.03)mg/L和(6.52±3.12)×109/L,细菌感染组SAA、CRP和WBC水平分别为(124.98±24.05)mg/L、(17.14±2.73)mg/L和(13.61±2.52)×109/L,病毒感染组SAA、CRP和WBC水平分别为(265.28±39.17)mg/L、(12.33±2.39)mg/L和(7.17±3.21)×109/L;经分析,细菌感染组SAA、CRP和WBC水平均高于健康对照组(P<0.05),病毒感染组SAA和CRP水平均高于健康对照组(P<0.05),病毒感染组SAA高于细菌感染组(P<0.05),病毒感染组CRP和WBC低于细菌感染组(P<0.05),差异有统计学意义。当SAA、CRP和WBC分别取118.62 mg/L、11.85 mg/L和9.24×109/L为临界值时诊断效能最大,分别为0.835、0.796和0.561,3项指标的联合诊断效能为0.922。结论 SAA、CRP和WBC检测对于儿童呼吸道感染的诊断和鉴别诊断具有重要诊断价值,临床应用时可对该3项指标同时进行检测,指导临床合理用药,值得推广和应用。

Objective To explore the value of serum amyloid A(SAA),C-reactive protein(CRP),and blood routine test in the early diagnosis of respiratory infection in children.Methods 186 cases of children with respiratory infection admitted to our hospital from July 2017 to June 2018 were selected as research subjects,including 96 cases of bacterial infection(bacterial infection group)and 90 cases of virus infection(virus infection group),100 healthy children were selected as the controls(healthy control group)during the same time period.The levels of SAA and CRP as well as white blood cell count(WBC)were measured for all subjects,and the efficacy of SAA,CRP,and WBC in early diagnosis and differential diagnosis of respiratory infection in children were analyzed.Results The levels of SAA,CRP,and WBC in the healthy control group were(4.96±1.02)mg/L,(3.52±1.03)mg/L,and(6.52±3.12)×109/L,those in the bacterial infection group were(124.98±24.05)mg/L,(17.14±2.73)mg/L,and(13.61±2.52)×109/L,those in the virus infection group were(265.28±39.17)mg/L,(12.33±2.39)mg/L,and(7.17±3.21)×109/L.The levels of SAA,CRP,and WBC in the bacterial infection group were higher than those in the healthy control group(P<0.05),the levels of SAA and CRP in the virus infection group were higher than those in the healthy control group(P<0.05),the level of SAA in the virus infection group was higher than that in the bacterial infection group(P<0.05),the levels of CRP and WBC in the virus infection group were lower than those in the bacterial infection group(P<0.05).Through the ROC curve analysis,the highest diagnostic efficiency were 0.835,0.796,and 0.561 when the levels of SAA,CRP,and WBC were 118.62 mg/L,11.85 mg/L,and 9.24×109/L,respectively,and the combined diagnostic efficiency of the three indicators was 0.922.Conclusion The detection of SAA,CRP,and WBC levels are of great values for the diagnosis and differential diagnosis of respiratory infection in children.The three indicators can be tested at the same time to guide rational use of drugs in clinical application,which is worthy of promotion.