动态监测CRP、SAA和IL-6在儿童甲型流感诊断和治疗中的价值

Value of dynamic monitoring of c-reaction protein,serum amyloid A and interleukin-6 in the diagnosis and treatment of influenza A in children

目的本文旨在探讨动态监测C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)和白介素6(IL-6)在儿童甲型流感诊断和治疗中的价值。方法选取2019年7月-12月在广州中医药大学深圳医院儿科就诊的甲型流感确诊儿童392例,健康对照组185例,综合比较WBC、CRP、SAA及IL-6单一检测及联合检测的诊断结果,并动态监测CRP、SAA和IL-6在治疗0d、3d、7d和10d的检测结果。结果与健康对照组相比,甲型流感组的WBC和CRP没有显著差异,SAA和IL-6显著升高(P<0.05),经过t检验和方差分析进一步发现,SAA检验组t=29.84,P<0.001;IL-6检验组t=16.64,P<0.001。SAA和IL-6对于甲型流感患者的阳性检出率分别为86.99%和88.52%。SAA和IL-6联合检测的诊断准确性显著高于两者的单一检测(P<0.05)。动态监测CRP、SAA和IL-6发现,治疗有效后SAA和IL-6的下降幅度更明显(P<0.05)。结论 SAA和IL-6联合检测可以有效鉴别诊断儿童甲型流感,诊断准确性更优高,动态监测CRP、SAA和IL-6尤其是后两个指标为临床治疗提供更有力的指导依据。

Objective The purpose of this study was to investigate the value of dynamic monitoring of C-reactive protein(CRP),serum amyloid A(SAA)and interleukin-6(IL-6)in the diagnosis and treatment of influenza A in children.Methods 392 cases of children with influenza A admitted to the pediatric department of Shenzhen Hospital of Guangzhou University of traditional Chinese medicine from July to December 2019 were selected,and 185 cases as healthy control group.The single and combined diagnostic results of WBC,CRP,SAA and IL-6 were compared comprehensively.The detection results of CRP,SAA and IL-6 in 0,3,7 and 10 days of treatment were monitored dynamically.Results There was no significant difference in WBC and CRP while SAA and IL-6 were significantly higher(P<0.05)compared with the control group.After t test and analysis of variance,SAA test group,t=29.84,P<0.001;IL-6 test group,t=16.64,P<0.001.The positive rates of SAA and IL-6 were 86.99%and 88.52%respectively.The diagnostic accuracy of the combined detection of the two indexes was significantly higher than that of the single detection(P<0.05).The dynamic monitoring of the three indexes showed that decrease of SAA and IL-6 was more significant than CRP(P<0.05).Conclusion Combined detection of SAA and IL-6 can effectively differentiate and diagnose influenza A in children,with better diagnostic accuracy.Besides,the dynamic monitoring of CRP,SAA and IL-6 especially the latter two can provide more powerful guidance for clinical treatment.