肺炎支原体肺炎患儿血清SAA、CRP和PCT水平的变化及意义

Changes and Significance of Serum SAA,CRP and PCT Levels in Children with Mycoplasma Pneumoniae Pneumonia

目的探讨肺炎支原体肺炎(MPP)患儿血清淀粉样蛋白A(serum amyloid A,SAA)、C反应蛋白(C-reactive protein,CRP)和降钙素原(procalcitonin,PCT)水平的变化及意义。方法选取2017年5月至2020年7月江苏省淮安市妇幼保健院收治的155例MPP患儿为研究对象。按病情分为轻症组(急性期、恢复期)和重症组(急性期、恢复期),同期选取50例健康儿童作为对照组。检测血清SAA、CRP、PCT水平;对比三组患儿SAA、CRP、PCT水平情况,对比轻症组与重症组SAA、CRP、PCT峰值水平和异常维持时间;分析诊断重症MPP效能。结果无论在轻症组还是重症组中,急性期SAA、CRP、PCT水平均高于恢复期(P<0.05);重症组急性期、恢复期SAA、CRP、PCT水平分别高于轻症组急性期、恢复期对应指标(P<0.05);轻症组恢复期SAA、CRP、PCT高于对照组对应指标(P<0.05)。与轻度组比较,重症组SAA、CRP、PCT峰值较轻症组更高,异常时间较轻症组更长(P<0.05)。血清SAA诊断重症MPP灵敏度、特异度为92.18%、82.43%;CRP灵敏度、特异度分别为68.54%、65.72%;PCT灵敏度、特异度分别为91.03%、91.87%。结论血清SAA、CRP和PCT有助于MPP诊断和病情评估,具有较高灵敏度和特异度,值得推广。

Objective To investigate the changes and significance of serum SAA,CRP and PCT levels in children with mycoplasma pneumoniae pneumonia(MPP).Methods From May 2017 to July 2020,155 children with MPP admitted in Jiangsu Huaian Maternal and Child Health Hospital were selected as the research objects.They were divided into mild group(acute stage,convalescent stage)and severe group(acute stage,convalescent stage),and 50 healthy children were selected as control group.The serum levels of SAA,CRP and PCT were detected;the levels of SAA,CRP and PCT were compared among three groups;the peak levels of SAA,CRP and PCT and abnormal maintenance time were compared between mild group and severe group;the efficacy of diagnosis of severe MPP was analyzed.Results The levels of SAA,CRP and PCT in the acute stage were higher than those in the recovery stage in both mild and severe groups(P<0.05);the levels of SAA,CRP and PCT in the acute stage and recovery stage in the severe group were higher than those in the mild group(P<0.05);the levels of SAA,CRP and PCT in the recovery stage in the mild group were higher than those in the control group(P<0.05).Compared with mild group,SAA,CRP,PCT peak value of severe group was higher than that of mild group,and abnormal time of severe group was longer than that of mild group(P<0.05).The sensitivity and specificity of SAA,CRP and PCT were 92.18%and 82.43%,68.54%and 65.72%,91.03%and 91.87%,respectively.Conclusion Serum SAA,CRP and PCT are helpful to the diagnosis and evaluation of MPP,with high sensitivity and specificity,which is worthy of promotion.