血清淀粉样蛋白A与儿童肺炎支原体肺炎病情程度的关系

Relationship between serum amyloid A and disease severity of Mycoplasma pneumoniae pneumonia in children

目的探讨血清淀粉样蛋白A(SAA)与儿童肺炎支原体肺炎(MPP)病情程度的关系。方法回顾性分析210例MPP患儿的临床资料。根据常规治疗1周后的病情,将患儿分为难治性MPP(RMPP)组48例和普通MPP(GMPP)组162例。比较急性期及恢复期两组患儿的SAA水平。采用受试者工作特征(ROC)曲线分析急性期SAA水平对MPP患儿发生RMPP的预测价值。结果急性期RMPP组患儿SAA水平高于GMPP组(P<0.05);恢复期两组的SAA水平较急性期下降(P<0.05),且两组间差异无统计学意义(P>0.05)。急性期SAA水平预测MPP患儿发生RMPP的ROC曲线下面积为0.872(P<0.05),当截断值为232.4 ng/mL时,灵敏度为76.7%,特异度为89.13%。结论急性期SAA水平可以反映MPP病情的严重程度,可作为早期识别RMPP的依据。

Objective To explore the relationship between serum amyloid A(SAA)and disease severity of Mycoplasma pneumoniae pneumonia(MPP)in children.Methods The clinical data of 210 children with MPP were retrospectively analyzed.The children were allocated to refractory MPP(RMPP)group(n=48)or general MPP(GMPP)group(n=162)according to the condition after one week of routine therapy.SAA level in acute or recovery stage was compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of SAA level in acute stage for developing RMPP in MPP children.Results The RMPP group yielded an increased SAA level in acute stage as compared with the GMPP group(P<0.05);SAA level in recovery stage was declined in both groups in contrast to the level in acute stage(P<0.05),but no statistically significant difference was found between the two groups(P>0.05).For predicting the occurrence of RMPP in MPP children,SAA level in acute stage obtained an area under ROC curve of 0.872(P<0.05),and presented a sensitivity of 76.7%and a specificity of 89.13%when the cut-off value was 232.4 ng/mL.Conclusion SAA level in acute stage can reflect the severity of MPP,and can be used as a basis for early identification of RMPP.