甲流和乙流患儿几种感染指标的变化及临床分析

Changes and Clinical Analysis of Several Infection Indexes in Children with Influenza A and B

目的探讨血清淀粉样蛋白A(SAA)及C-反应蛋白(CRP)和SAA/CRP比值及白细胞(WBC)计数等指标在甲流和乙流患儿的变化及其临床价值。方法选取2019年5月~7月诊断为甲流的101例患儿设为甲流组,诊断为乙流的112例患儿设为乙流组,另选健康儿童100例设为对照组,比较各组SAA、CRP、SAA/CRP比值和WBC等指标的水平变化,用ROC曲线分析各指标诊断甲流和乙流的价值。结果甲流组和乙流组的SAA和SAA/CRP比值均高于对照组(P<0.05);甲流组CRP水平高于对照组,乙流组CRP与对照组比较,无差异无统计学意义(P>0.05);甲流组和乙流组的淋巴细胞绝对值低于对照组(P<0.05)。ROC曲线分析显示,各指标中SAA诊断甲流和乙流的价值较高,分别为0.816(0.749~0.883),0.803(0.740~0.866)。而SAA、CRP和SAA/CRP比值联合应用中性粒细胞绝对值和淋巴细胞绝对值诊断儿童甲流和乙流的AUC分别为0.828(0.765~0.892),0.844(0.740~0.898)。结论SAA、CRP和SAA/CRP比值联合应用中性粒细胞和淋巴细胞绝对值有利于早期诊断儿童甲流和乙流。

Objective To evaluate the clinical value of serum amyloid protein(SAA),C-reactive protein(CRP),SAA/CRP ratio and white blood cells(WBC)count etc in diagnosis of influenza A and influenza B in children.Methods Selecting 101 children diagnosed with influenza A from May to July 2019 as the influenza A group,112 children diagnosed with influenza B as the influenza B group,and 100 healthy children as the control group.The changes in the levels of SAA,CRP,SAA/CRP ratio and WBC and other indicators in each group,and the ROC curve was used to analyze the value of each indicator in diagnosing influenza A and influenza B.Results Levels of SAA and SAA/CRP ratio in both influenza A and influenza B group were significantly higher than those in the control group(P<0.05).The CRP level of the influenza A group was higher than that of the control group,and the CRP level of the influenza B group was not statistically significant compared with the control group(P>0.05);The absolute value of lymphocytes in influenza A group and influenza B group was lower than the control group(P<0.05).ROC curve analysis showed that SAA had a higher value in diagnosing influenza A and B among the indicators,which were 0.816(0.749-0.883)and 0.803(0.740-0.866)respectively.The AUC of SAA,CRP and SAA/CRP ratio combined with absolute value of neutrophils and absolute value of lymphocytes to diagnose children with influenza A and B was 0.828(0.765-0.892)and 0.844(0.740-0.898).Conclusion The combined application of SAA,CRP and SAA/CRP ratio with absolute values of neutrophils and lymphocytes is beneficial for early diagnosis of influenza A and B in children.