血清淀粉样蛋白A与降钙素原水平检测在儿童感染性疾病中的诊断价值

Diagnostic Value of Serum Amyloid A and Procalcitonin Level in Children with Infectious Diseases

目的探讨血清淀粉样蛋白A(SAA)及降钙素原水平(PCT)在儿童感染性疾病中的诊断价值。方法回顾性分析2019年3~8月于广州中医药大学第一附属医院就诊的150例感染性疾病患儿的临床资料。其中,80例细菌感染患儿纳入细菌感染组,70例病毒感染患儿纳入病毒感染组,另随机选取50例同期于该院体检健康儿童纳入对照组。采集三组血液样本,检测三组样本血清SAA及PCT水平,并分析其临床诊断价值。结果三组血清SAA及PCT水平比较,差异均有统计学意义(F=17.383,11.169,均P﹤0.05);细菌感染组和病毒感染组血清SAA水平与对照组比较,差异均有统计学意义(t=13.795,10.247,均P﹤0.05);细菌感染组血清PCT水平与病毒感染组及对照组比较,差异均有统计学意义(t=15.005,18.146,均P﹤0.05);三组血清SAA及PCT阳性率比较,差异均有统计学意义(χ^2=9.706,26.092,均P<0.05)。细菌感染组和病毒感染组SAA阳性率均高于对照组(χ^2=8.273,6.318,均P<0.05)。细菌感染组PCT阳性率高于病毒感染组及对照组(χ^2=14.268,19.042,均P值﹤0.05)。由ROC曲线图可知,细菌感染组SAA及PCT曲线下面积分别为0.785及0.824,病毒感染组SAA及PCT曲线下面积分别为0.813及0.551。SAA对病毒感染的诊断特异度较高,PCT对细菌感染的诊断特异度较高,SAA与PCT联合诊断细菌感染的敏感度为92.18%,特异度为88.03%;SAA与PCT联合诊断病毒感染的敏感度为80.14%,特异度为86.52%。结论 SAA诊断病毒感染的敏感度较高,PCT诊断细菌感染的敏感度较高,SAA与PCT联合检测可有效诊断儿童感染性疾病。

Objective To investigate the diagnostic value of serum amyloid A(SAA) and procalcitonin(PCT) levels in children with infectious diseases. Methods Retrospective analysis of clinical data of 150 children with infectious diseases who were treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2019 to August 2019.Among them, 80 children with bacterial infection were included in the bacterial infection group, 70 children with viral infection were included in the virus infection group, and another 50 healthy children randomly selected from the First Affiliated Hospital of Guangzhou University of Chinese Medicine during the same period were included in the control group.Three groups of blood samples were collected, and the levels of serum SAA and PCT were measured in three groups, and the clinical diagnostic value was analyzed. Results There were significant differences in serum SAA and PCT levels between the three groups(F =17.383,11.169,all P<0.05). The serum SAA levels in the bacterial infection group and the virus infection group were significantly different from those in the control group(t =13.795,10.247,all P< 0.05). There were significant differences in serum PCT levels between the virus-infected group and the control group(t =15.005, 18.146,all P < 0.05). The positive rates of serum SAA and PCT in the three groups were statistically significant(χ^2 =9.706, 26.092,all P < 0.05).Bacterial infection group and virus positive rate of SAA in the infection group was higher than that in the control group(χ^2 =8.273, 6.318,all P < 0.05). The positive rate of PCT in the bacterial infection group was higher than that in the virus infection group and the control group(χ^2 =14.268, 19.042,all P < 0.05). From the ROC curve, the SAA and PCT curves of the bacterial infection group were observed. The areas were 0.785 and 0.824, respectively, and the area under the SAA and PCT curves of the virus-infected group were 0.813 and 0.551, respectively. SAA had higher diagnostic specificity for viral infection and PCT had higher diagnostic specificity for bacterial infection. SAA combined with PCT to diagnose bacteria, the sensitivity of infection was 92.18% and the specificity was 88.03%. The sensitivity of SAA combined with PCT to diagnose viral infection was 80.14% and the specificity was 86.52%.Conclusion The sensitivity of SAA for the diagnosis of viral infection is high, and the sensitivity of PCT for the diagnosis of bacterial infection is high. The combined detection of SAA and PCT can effectively diagnose infectious diseases in children.