外周血CD64指数和血清淀粉样蛋白A检测在学龄前儿童细菌感染诊断中的临床意义

The Clinical Significance of the Detection of Peripheral Blood CD64 Index and Serum Amyloid A in the Diagnosis of Bacterial Infection in Preschool Children

目的:研究外周血CD64指数与血清淀粉样蛋白A(SAA)检测在学龄前儿童细菌感染诊断中的临床意义。方法:采用回顾性分析方法,研究对象为2018年1月至2020年1月入院的200例患感染性疾病学龄前儿童,参考不同病原体分为病毒感染患儿(病毒组,n=100)与细菌感染患儿(细菌组,n=100);同时,选取同期入院进行体检的健康儿童作为研究对象,设为健康组(n=100)。比较三组研究对象的CD64指数、SAA水平及阳性率,对比细菌组患儿抗生素治疗前后的CD64指数和SAA水平,并对CD64、SAA用于细菌感染诊断的效能进行分析。结果:对比病毒组、健康组,细菌组CD64指数、SAA水平明显更高,差异均有显著性(P<0.05);对比健康组,病毒组SAA水平明显更高,差异有显著性(P<0.05)。细菌组患儿治疗后较治疗前CD64指数、SAA水平明显降低,差异有显著性(P<0.05)。对比病毒组、健康组,细菌组CD64指数、SAA阳性率明显更高,差异均有显著性(P<0.016);对比健康组,病毒组SAA阳性率明显更高,差异有显著性(P<0.016)。细菌感染诊断中CD64指数的特异度、阳性预测值明显高于SAA,差异有显著性(P<0.05)。结论:学龄前儿童细菌感染诊断、疗效评估中CD64指数、SAA检测具有重要的临床价值,且CD64指数诊断价值更大。

Objective:To study the clinical significance of peripheral blood CD64 index and serum amyloid A(SAA)detection in the diagnosis of bacterial infections in preschool children.Methods:With the retrospective analysis method,200 preschool children with infectious diseases admitted from January 2018 to January 2020 were selected as the research subjects.According to different pathogens,they were divided into children with viral infections(virus group,n=100)and children with bacterial infections(bacterial group,n=100);at the same time,healthy children who were admitted to the hospital for physical examination during the same period were selected as the research subjects as the healthy group(n=100).Comparison was conducted on the CD64 index,SAA level and positive rate of the three groups of subjects,the CD64 index and SAA level before and after antibiotic treatment in the bacterial group,and the efficacy of CD64 and SAA in the diagnosis of bacterial infections was analyzed.Results:The CD64 index and SAA level of the bacterial group were significantly higher,and the difference was significant(P<0.05);compared with the healthy group,the SAA level of the virus group was significantly higher,and the difference was significant(P<0.05).The CD64 index and SAA levels of children in the bacterial group were significantly lower than those before treatment,and the difference was significant(P<0.05).Compared with the virus group and the healthy group,the bacterial group had a significantly higher CD64 index and SAA positive rate,and the difference was significant(P<0.016);compared with the healthy group,the virus group had a significantly higher SAA positive rate,and the difference was significant(P<0.016).The specificity and positive predictive value of CD64 index in the diagnosis of bacterial infection were significantly higher than SAA,and the difference was significant(P<0.05).Conclusion:CD64 index and SAA test have important clinical value in the diagnosis and evaluation of bacterial infection in preschool children,and CD64 index is more valuable in the diagnosis.