PCT、CRP、SAA联合检测在小儿呼吸道感染鉴别诊断中的价值分析

Value analysis of combined detection of PCT,CRP and SAA in differential diagnosis of respiratory infections in children

目的探讨降钙素原(PCT)、C反应蛋白(CRP)以及血清淀粉样蛋白A(SAA)联合检测对小儿呼吸道感染鉴别诊断的价值。方法选择2017年8月—2020年8月期间本院收治的符合纳入标准并确诊为呼吸道感染的190例患儿为观察对象,按感染情况分组,A组(细菌感染,共90例),B组(非细菌感染,共100例),同期择选于本院体检且健康儿童共90例为C组,检测A、B、C三组患儿的PCT、CRP以及SAA水平并分析A组治疗前后的PCT、CRP以及SAA水平变化。结果A组患儿的血清PCT、CRP以及SAA水平均显著高于B、C两组,差异有统计学意义(F=321.546、570.031、401.337,P<0.05);B、C两组的PCT、CRP以及SAA水平比较,差异无统计学意义(P>0.05);A组患儿PCT、CRP以及SAA水平阳性率以及三项联合检测阳性率均显著高于B、C两组,差异有统计学意义(χ^(2)=16.554、17.280、21.218、19.580,P<0.05);B组患儿PCT、CRP以及SAA水平阳性率稍高于C组,但两组差异无统计学意义(P>0.05);A组患儿经抗感染治疗72h后,血清PCT、CRP以及SAA水平明显低于治疗前,基本恢复正常且差异有统计学意义(t=6.678、7.903、8.432,P<0.05)。结论PCT、CRP以及SAA联合检测对小儿呼吸道感染的鉴别诊断有重要价值,能够为预后相关评估提供一定的参考依据。

Objective To explore the value of combined detection of procalcitonin(PCT),C-reactive protein(CRP)and serum amyloid A(SAA)in the differential diagnosis of respiratory tract infections in children.Methods 190 children who were admitted to our hospital from August 2017 to August 2020 who met the inclusion criteria and were diagnosed with respiratory tract infection were selected as observation objects,and divided into three groups according to infection status:Group A(bacterial infection,90 cases in total),group B(non-bacterial infection,100 cases in total).90 healthy children were selected in the hospital for physical examination at the same time as group C.And the three groups were tested.The levels of PCT,CRP and SAA were analyzed and the changes in the levels of PCT,CRP and SAA before and after treatment in group A were analyzed;the PCT and CRP before and after treatment in group A were analyzed;and SAA level changes were analyzed.Results The serum PCT,CRP and SAA levels of the children in group A were significantly higher than those of the two groups B and C,and the difference was statistically significant(F=321.546,570.031,401.337,P<0.05);There was no statistically significant difference between CRP and SAA levels(P>0.05);the positive rates of PCT,CRP,and SAA levels in group A and the positive rates of the three combined tests were significantly higher than those of B and C groups,and the difference was statistically significant(χ^(2)=16.554,17.280,21.218,19.580,P<0.05).The positive rates of PCT,CRP and SAA levels in group B were slightly higher than those in group C,but the difference between the two groups was not statistically significant(P>0.05).After 72h of anti-infection treatment,the serum PCT,CRP and SAA levels of children in the group were significantly lower than before treatment,and they were basically normal and the difference was statistically significant(t=6.678,7.903,8.432,P<0.05).Conclusions The combined detection of PCT,CRP and SAA is of great value in the differential diagnosis of respiratory tract infections in children,and can provide a certain reference basis for the evaluation of prognosis.