感染性腹泻患儿外周血TLR2、CD64、STREM-1水平及鉴别诊断价值研究

Peripheral Blood TLR2,CD64 and STREM-1 Levels in Children with Infectious Diarrhea and Their Value in Differential Diagnosis

目的:探究感染性腹泻患儿外周血Toll样受体2(TLR2)、中性粒细胞白细胞分化抗原64(CD64)、可溶性髓系细胞触发受体-1(STREM-1)水平及其对感染性腹泻的鉴别诊断价值。方法:选取2020年4月-2023年7月医院收治的64例感染性腹泻患儿作为研究对象,根据病原体类型分别细菌性腹泻组(n=33)与病毒性腹泻组(n=31),另选取同期30名入组前1周无腹泻症状的健康儿童作为对照组,三组均进行外周血TLR2、CD64、STREM-1水平测定,绘制受试者工作特征(ROC)曲线,分析三种指标对于感染性腹泻患儿的诊断价值。结果:细菌性腹泻组、病毒性腹泻组TLR2水平高于对照组,细菌性腹泻组CD64、STREM-1水平高于病毒性腹泻组与对照组(P<0.05)。ROC曲线分析结果显示STREM-1的曲线下面积(AUC)值最高,为0.777,敏感度、特异度分别为62.50%、93.33%;联合后AUC为0.839,敏感度显著升高,为84.37%,特异度为83.33%。结论:外周血TLR2、CD64、STREM-1水平诊断感染性腹泻患儿时,以STREM-1的诊断效能最高,三者联合诊断后可显著提升诊断敏感度,具有良好的临床应用价值。

Objective:To investigate peripheral blood Toll-like receptor 2(TLR2),cluster of differentiation antigen 64(CD64)and soluble triggering receptor expressed on myeloid cell-1(STREM-1)in children with infectious diarrhea,and their value in differential diagnosis of infectious diarrhea.Methods:A total of 64 children with infectious diarrhea admitted to the hospital from April 2020 to July2023 were selected,and divided into bacterial diarrhea group(n=33)and viral diarrhea group(n=31)according to the type of pathogen.Meanwhile,30 healthy children were selected as the control group.Peripheral blood TLR2,CD64,and STREM-1 levels in all groups were measured.The diagnostic value of the three indicators in children with infectious diarrhea was analyzed using the receiver operating characteristic(ROC)curves.Results:TLR2 levels in the bacterial diarrhea group and the viral diarrhea group were higher than those in the control group.CD64 and STREM-1 levels in the bacterial diarrhea group were higher than those in the viral diarrhea group and the control group(P<0.05).ROC curve analysis results showed that the area under the curve(AUC)of STREM-1 was the largest,which was0.777.Its sensitivity and specificity were 62.50%and 93.33%.The AUC of joint diagnosis was 0.839.The sensitivity and specificity were84.37%and 83.33%.Conclusion:For diagnosing children with infectious diarrhea using peripheral blood TLR2,CD64,and STREM-1,the diagnostic efficacy of STREM-1 is the highest.Combination of the three can significantly improve the diagnostic sensitivity.