小儿感染性疾病早期血清淀粉样蛋白A和超敏C反应蛋白水平的临床意义

Significance of detecting serum amyloid A and high⁃sensitivity C⁃reactive protein levels in early stage of infectious diseases in children

目的分析血清淀粉样蛋白A(SAA)和超敏C反应蛋白(hs-CRP)水平变化,探讨其在感染性疾病诊断中的应用价值。方法选取2022年1-12月甘肃省妇幼保健院收治的116例感染性疾病患儿为研究对象,根据病原体检测结果分为病毒感染组(n=77)和细菌感染组(n=39),另选取40名同期健康检查的儿童作为对照组。检测所有受试儿童血清SAA、hs-CRP、白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞百分比(NEUT%)、淋巴细胞百分比(LYM%)、血红蛋白(HGB)水平,计算SAA/hs-CRP比值,采用受试者工作特征(ROC)曲线评估SAA、hs-CRP、SAA/hs-CRP单独与联合检测在小儿感染早期诊断和治疗中的应用价值。结果3组受试儿童血清SAA、hs-CRP水平为细菌感染组>病毒感染组>对照组,差异均有统计学意义(F=5020.659、632.763,P均<0.05)。SAA/hs-CRP水平为病毒感染组>细菌感染组>对照组,差异有统计学意义(F=334.038,P<0.05)。血清SAA、hs-CRP、SAA/hs-CRP、WBC、NEUT%、LYM%水平均为小儿感染性疾病早期诊断的危险因素(P均<0.05)。ROC分析结果显示,血清SAA、hs-CRP、SAA/hs-CRP单一及联合检测诊断小儿感染性疾病曲线下面积分别为0.721、0.741、0.883、0.921。联合检测诊断灵敏度及特异度较单一检测高(P均<0.001)。结论血清SAA、hs-CRP、SAA/hs-CRP联合检测在小儿感染性疾病早期鉴别及诊断中具有良好的应用价值,为临床抗感染治疗提供依据。

Objective To investigate the changes of serum amyloid A(SAA)and hypersensitive C⁃reactive protein(hs⁃CRP)levels in the early stage of infective diseases in children and their diagnostic value.Methods A total of 116 children with infectious diseases admitted to the Gansu Provincial Maternal and Child Health Care Hospital from January 2022 to December 2022 were selected as research objects.And based on the results of pathogen testing,they were divided into viral infection group(n=77)and bacterial infection group(n=39).Another 40 children who underwent health examination in our hospital during the same period were selected as control group.The serum levels of SAA,hs⁃CRP and SAA/hs⁃CRP were compared in the three groups of children at the early stage of infection,and the application value of single and combined detection of SAA,hs⁃CRP and SAA/hs⁃CRP in the early diagnosis and treatment of infantilism was evaluated.Results The levels of serum SAA and hs⁃CRP in the three groups were bacterial infection group>viral infection group>control group,the differences were statistically significant(F=5020.659,632.763;all P<0.05).The level of SAA/hs⁃CRP was virus infection group>bacterial infection group>control group,the differences were statistically significant(F=334.038,P<0.05).Serum levels of SAA,hs⁃CRP,SAA/hs⁃CRP,WBC,NEUT%,LYM%were risk factors for early diagnosis of infective diseases in children(all P<0.05).ROC analysis results showed that the areas under the curve of serum SAA,hs⁃CRP and SAA/hs⁃CRP for distinguishing early childhood infectious diseases were 0.721,0.741,0.883 and 0.921 respectively.Conclusion Serum SAA,hs⁃CRP,SAA/hs⁃CRP combined detection had good application value in early identification and diagnosis of infective diseases in children,and could provide an important basis for clinical anti⁃infective treatment.