SAA、CRP、LYMPH#、NT-proBNP、DD在COVID-19中的临床价值

Clinical roles of SAA,CRP,LYMPH#,NT-proBNP and DD in COVID-19

目的探讨血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)、淋巴细胞绝对数(LYMPH#)、氨基末端B型钠尿肽原(NT-proBNP)、D-二聚体(DD)在新型冠状病毒肺炎(COVID-19)诊断中的价值。方法选取COVID-19患者98例,其中普通型64例、重型20例、危重型14例,以40例排除严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的发热患者作为对照组。检测所有对象SAA、CRP、LYMPH#、NTproBNP、DD水平。同时动态监测危重型和重型COVID-19患者住院期间各项指标的变化。采用受试者工作特征(ROC)曲线评估各项指标诊断COVID-19的效能。结果COVID-19危重型组、重型组SAA、CRP、LYMPH#、NT-proBNP、DD与普通型组、对照组比较,差异均有统计学意义(P<0.05、P<0.01)。普通型组与对照组之间各项指标差异均无统计学意义(P>0.05)。将重型和危重型COVID-19患者合并为1组。ROC曲线分析结果显示,SAA、CRP、LYMPH#、NT-proBNP、DD诊断重型及危重型COVID-19的曲线下面积分别为0.930、0.872、0.846、0.731、0.815。连续监测结果显示,危重型COVID-19患者的SAA、CRP、NT-proBNP、DD持续维持在较高水平,至21 d左右开始降低;LYMPH#持续维持在较低水平,到21 d左右开始逐渐升高。重型COVID-19患者5项指标波动不大。结论SAA、CRP、LYMPH#、NT-proBNP、DD可作为COVID-19的辅助诊断指标,动态监测这5项指标对判断COVID-19病情和转归有重要的参考价值。

Objective To investigate the roles of serum amyloid A(SAA),C-reactive protein(CRP),the absolute value of lymphocyte(LYMPH#),N-terminal B type natriuretic peptide(NT-proBNP)and D-dimer(DD)in the diagnosis of corona virus disease 2019(COVID-19).Methods A total of 98 patients with COVID-19 were enrolled,and there were 64 cases of common type,20 cases of severe type and 14 cases of critical type.Totally,40 fever patients excluding severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection were enrolled as control group.SAA,CRP,LYMPH#,NT-proBNP and DD levels were determined.The changes of the indexes of COVID-19 critical and severe patients during hospitalization were monitored dynamically.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency of each index for COVID-19.Results There were statistical significance of SAA,CRP,LYMPH#,NT-proBNP and DD in critical group,severe group and common type group of COVID-19(P<0.05,P<0.01).There was no statistical significance between common type group and control group(P>0.05).Severe patients and critical patients with COVID-19 were combined into a group.ROC curve analysis showed that the areas under curves of SAA,CRP,LYMPH#,NT-proBNP and DD in the diagnosis of severe and critical COVID-19 was 0.930,0.872,0.846,0.731 and 0.815,respectively.The continuous monitoring results showed that SAA,CRP,NT-proBNP and DD of critical group were maintained at high levels,and began to decrease at about the 21 day.LYMPH#continued to maintain at a low level,and began to increase gradually at about the 21 day.The 5 indexes of severe group did not fluctuate significantly.Conclusions SAA,CRP,LYMPH#,NT-proBNP and DD can be used as auxiliary diagnostic indicators of COVID-19.Dynamic monitoring of the 5 indicators has reference value for the judgment and prognosis of COVID-19.