CD64指数和血清淀粉样蛋白A检测在学龄前儿童细菌感染诊断和鉴别诊断中的意义

Significance of CD64 and SAA detection in diagnosis and differential diagnosis of preschool children's bacterial infection

目的探讨外周血CD64指数和血清淀粉样蛋白A(SAA)检测在学龄前儿童细菌感染诊断和鉴别诊断中的意义。方法选取50例细菌感染患儿、50例病毒感染患儿和50例健康体检儿童,比较各组CD64、SAA水平及阳性率,并分析CD64、SAA诊断细菌感染的效能。结果细菌感染组外周血CD64指数和SAA水平显著高于病毒感染组和对照组(P<0.05),病毒感染组SAA水平显著高于对照组(P<0.05);经有效抗生素治疗后,细菌感染组CD64和SAA水平均呈明显下降趋势(P<0.05)。CD64诊断细菌感染的敏感度为84.0%、特异度为88.0%、约登指数为0.720,SAA诊断细菌感染的敏感度为94.0%、特异度为32.0%、约登指数为0.260;细菌感染患儿CD64和SAA呈正相关(r=0.791,P<0.05)。结论 CD64和SAA检测在细菌感染的诊断、鉴别诊断和疗效监测中有重要临床价值,且CD64的诊断价值优于SAA。

Objective To explore the significance of detecting peripheral blood CD64 index and semm amyloid A(SAA)in the diagnosis and differential diagnosis of bacterial infection in preschool children.Methods 50 children with bacterial infections,50 children with viral infections,and 50 healthy children were selected,the levels of CI)64 and SAA and the positive rate were compared among the three groups,and the efficacy of CD64 and SAA in diagnosing bacterial infection was analyzed.Results The CD64 index and SAA level in the peripheral blood of the bacterial infection group were significantly higher than those of the viral infection group and the healthy control group(P<0.05).SAA levels in the virus-infected group were significantly higher than those in the healthy control group(P<0.05).After effective antibiotic treatment,the levels of CD64 and SAA in the bacterial infection group showed a significant decrease(P<0.05).The sensitivity of CD64 with bacterial infection was 84.0%,the specificity was 88.0%,the positive predictive value was 87.5%,the negative predictive value was 86.3%,the Youden index was 0.720,and the SAA was 94.0%,32.0%,58.0%,84.2%,0.260,respectively,and there was a positive correlation between CD64 and SAA in children with bacterial infection(r = 0.791 ,P<0.05).Conclusion The detection of peripheral blood CD64 and serum SAA has important application value in the diagnosis,differential diagnosis and curative effect monitoring of bacterial infection,and the diagnostic value of CD64 is better than SAA.