血清淀粉酶样蛋白A在儿童感染性疾病中的临床应用

Clinical application of serum amylase-like protein A in children with infectious diseases

目的探讨血清淀粉酶样蛋白A(SAA)在儿童感染性疾病中的应用价值。方法选取168例细菌或病毒感染患儿,根据细菌培养结果分为病毒感染组(90例)和细菌感染组(78例);另选取体检的64例健康儿童作为健康儿童组。比较三组SAA、白细胞计数、C反应蛋白(CRP)和中性粒细胞/淋巴细胞比值,比较SAA、白细胞计数、CRP检测细菌感染的灵敏度、特异度。结果病毒感染组的SAA、白细胞计数、CRP高于健康儿童组,中性粒细胞/淋巴细胞比值低于健康儿童组;细菌感染组的SAA、白细胞计数、CRP、中性粒细胞/淋巴细胞比值高于健康儿童组;细菌感染组的SAA、白细胞计数、CRP、中性粒细胞/淋巴细胞比值均高于病毒感染组;差异均有统计学意义(P<0.05)。SAA对细菌感染的灵敏度为92.3%(72/78)、特异度为80.0%(72/90);白细胞计数对细菌感染的灵敏度为75.6%(59/78)、特异度为61.1%(55/90);CRP对细菌感染的灵敏度为80.8%(63/78)、特异度为66.7%(60/90);SAA对细菌感染的灵敏度和特异度均高于白细胞计数、CRP,差异有统计学意义(P<0.05)。结论在儿科感染性疾病的诊断中,血清学SAA、白细胞计数、CRP等均可作为判断感染分类的诊断指标,血清学SAA具有高敏感性,在机体发生感染时呈过量表达,可在疾病早期为临床提供诊断和治疗重要依据。

Objective To discuss the application value of serum amylase-like protein A(SAA)in children with infectious diseases.Methods A total of 168 children with bacterial or viral infections were divided into viral infection group(90 cases)and bacterial infection group(78 cases)according to the results of bacterial culture.Another 64 healthy children were selected as the healthy children group.Comparison was made on the SAA,white blood cell count,C-reactive protein(CRP)and neutrophil/lymphocyte ratio among the three groups,and the sensitivity and specificity of SAA,white blood cell count,and CRP detection for infection.Results The SAA,white blood cell count,and CRP of the virus infection group were higher than those of the healthy children group,and the neutrophil/lymphocyte ratio was lower than that of the healthy children group;the SAA,white blood cell count,CRP,and neutrophil/lymphocyte ratio of the bacterial infection group were higher than those of the healthy children group;the SAA,white blood cell count,CRP,and neutrophil/lymphocyte ratio of the bacterial infection group were higher than those of the virus infection group.All the differences were statistically significant(P<0.05).SAA had a sensitivity of 92.3%(72/78)and a specificity of 80.0%(72/90)for bacterial infections;white blood cell count had a sensitivity of 75.6%(59/78)and a specificity of 61.1%(55/90)for bacterial infections;CRP had a sensitivity of 80.8%(63/78)and a specificity of 66.7%(60/90)for bacterial infections.The sensitivity and specificity of SAA to bacterial infection were higher than white blood cell count and CRP,and the difference was statistically significant(P<0.05).Conclusion In the diagnosis of infectious diseases in children,serum SAA,white blood cell count and CRP can be used as diagnostic indicators to determine the classification of infection.Serum SAA is highly sensitive and is overexpressed when infection occurs in the organism,which can provide an important basis for clinical diagnosis and treatment in the early stage of the disease.