血清SAA/CRP、CD64对儿童甲型流感早期诊断的临床价值分析

Analysis on the clinical value of serum SAA/CRP and CD64 in early diagnosis of influenza A in children

目的探讨血清淀粉酶A蛋白(SAA)与C-反应蛋白(CRP)比值SAA/CRP、中性粒细胞表面抗原CD64对儿童甲型流感早期诊断的临床价值。方法选择2017年8月~2019年2月来医院儿科就诊的125例流感症状患儿作为研究对象,根据患儿临床诊断结果将其分为甲型流感组31例、非甲型流感组94例;再选择同期在天津海河教育园区达文路卫生服务中心健康体检健康儿童30例作为对照组。患儿入组后立即留取鼻咽吸取液,采用RT-PCR鉴定流感病毒型别;采集末梢血进行7项呼吸道病毒联合检测及血清SAA、CRP以及外周血中性粒细胞表面抗原CD64表达水平。结果甲型流感组与非甲型流感组患儿血清SAA、SAA/CRP以及CD64指数显著高于对照组,甲型流感组血清SAA、SAA/CRP以及CD64指数显著高于非甲型流感组,差异均有统计学意义(P<0.05),3组儿童血清CRP水平比较差异无统计学意义(P>0.05)。运用ROC曲线分析在疑似甲型流感125例患儿中血清SAA、CRP、SAA/CRP以及CD64对甲型流感诊断价值,结果显示各指标诊断曲线下面积分别为0.908、0.641、0.994、0.957。结论甲型流感患儿血清SAA、SAA/CRP以及中性粒细胞表面受体CD64表达显著升高,在甲型流感患儿的早期临床诊断中具有较高的辅助价值。

Objective To explore the clinical value of serum amylase A protein(SAA)/C-reactive protein(CRP)and CD64 in early diagnosis of influenza A in children.Methods A total of 125 children with influenza symptoms were selected from Department of Pediatrics from August 2017 to February 2019,then they were divided into influenza A group(31 children)and non-influenza A group(94 children)according to clinical diagnostic results.Thirty healthy children were selected from Health Service Center of Dawen Road during the same period as control group.The nasopharyngeal fluid was collected immediately after admission,influenza virus types were identified by RT-PCR.The peripheral blood samples were collected to detect 7 respiratory viruses,the levels of serum SAA and CRP,the expression levels of CD64.Results The levels of serum SAA,SAA/CRP,and CD64 index in influenza A group and non-influenza A group were statistically significantly higher than those in control group,the levels of serum SAA,SAA/CRP,and CD64 index in influenza A group were statistically significantly higher than those in non-influenza A group(P<0.05).There was no statistically significant difference in serum CRP level among the three groups(P>0.05).ROC analysis showed that the areas under the curve of serum SAA,CRP,SAA/CRP,CD64 in diagnosis of influenza A in children were 0.908,0.641,0.994,0.957,respectively.Conclusion The expression levels of serum SAA,SAA/CRP,and neutrophil surface receptor CD64 in children with influenza A increase significantly,which have high value in early clinical diagnosis of influenza A in children.