肺炎支原体感染儿童血清淀粉样蛋白A含量检测价值

Detection Value of Serum Amyloid a Level in Children with Mycoplasma Pneumoniae Infection

目的探讨血清淀粉样蛋白A(SAA)在肺炎支原体肺炎(MPP)儿童诊断和预后评价中的价值。方法选取2018年1月~2019年12月安新县医院收治的MPP患儿65例为MPP组,另选取同期我院健康体检儿童65例为健康对照组。比较两组血浆SAA水平,并分析SAA水平与MPP严重程度和预后的关系及SAA对MPP诊断和预后效能。结果MPP组主要肺功能指标低于健康对照组,重症组主要肺功能指标低于轻症组,差异均有统计学意义(P<0.05);MPP组SAA水平高于健康对照组,重症组SAA水平高于轻症组,差异均有统计学意义(P<0.05);预后良好48例,预后不佳17例,预后不佳组SAA水平高于预后良好组,差异有统计学意义(P<0.05);MPP组的SAA水平与疾病程度呈正相关,与疾病预后及肺功能指标(FEV_(1)、FVC和FEV_(1)/FVC)呈负相关;MPP诊断的ROC曲线AUC为0.837(95%CI:0.815~0.943)。以SAA=5.27μg/ml为cut off值,MPP诊断的敏感性为85.91%,特异性为78.19%;MPP预后的ROC曲线AUC为0.884(95%CI:0.837~0.968);以SAA=16.31μg/ml为cut off值,MPP预后的敏感性为90.82%,特异性为81.33%。结论SAA水平与MPP患儿疾病进展和预后有关,可用作疾病的监测指标,对MPP的辅助诊断和预后判定有重要的临床价值。

Objective To explore the value of serum amyloid A(SAA)in the diagnosis and prognostic evaluation of children with Mycoplasma pneumoniae pneumonia(MPP).Methods 65 children with MPP admitted to Anxin County Hospital from January 2018 to December 2019 were selected as the MPP group,and 65 children with healthy physical examination in our hospital during the same period were selected as the healthy control group.The plasma SAA levels of the two groups were compared,and the relationship between SAA levels and the severity and prognosis of MPP and the diagnostic and prognostic efficacy of SAA on MPP were analyzed.Results The main lung function indexes of the MPP group were lower than those of the healthy control group,and the main lung function indexes of the severe group were lower than those of the mild group,the differences were statistically significant(P<0.05);The SAA level of the MPP group was higher than that of the healthy control group,and the SAA level of the severe group was higher than that of the mild group,the difference was statistically significant(P<0.05);48 cases had a good prognosis and 17 cases had a poor prognosis.The SAA level of the poor prognosis group was higher than that of the good prognosis group,the difference was statistically significant(P<0.05);The SAA level in the MPP group was positively correlated with the disease degree,and negatively correlated with the disease prognosis and lung function indicators(FEV_(1),FVC and FEV_(1)/FVC);The ROC curve AUC of MPP diagnosis was 0.837(95%CI:0.815-0.943).Taking SAA=5.27μg/ml as the cut off value,the sensitivity of MPP diagnosis was 85.91%,and the specificity was 78.19%;The ROC curve AUC of the prognosis of MPP was 0.884(95%CI:0.837-0.968);with SAA=16.31μg/ml as the cut off value,the prognostic sensitivity of MPP was 90.82%and the specificity was 81.33%.Conclusion The SAA level is related to the disease progression and prognosis of children with MPP.It can be used as a disease monitoring index and has important clinical value for the auxiliary diagnosis and prognosis determination of MPP.