PCT和SAA检测在学龄前儿童早期细菌性感染中的意义  

The significance of PCT and SAA detection in early childhood bacterial infection in preschool children

作　　者：宁兴旺[1] 苏敏 钱纯[1] 谢小兵[1] 朱惠斌[1] NING Xingwang;SU Min;QIAN Chun;XIE Xiaobing;ZHU Huibin(Department of Medical Laboratory,the First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007,China)

机构地区：[1]湖南中医药大学第一附属医院医学检验中心,长沙410007

出　　处：《国际检验医学杂志》2018年第8期925-928,共4页International Journal of Laboratory Medicine

摘　　要：目的探讨降钙素原(PCT)和血清淀粉样蛋白A(SAA)在学龄前儿童早期细菌性感染中的临床意义。方法选择67例细菌性感染患儿(细菌感染组)、62例病毒性感染患儿(病毒感染组)和60例健康儿童(健康对照组)作为研究对象,分别采用胶乳增强免疫比浊法检测SAA水平和免疫比浊法检测PCT水平,比较各组患者SAA和PCT水平及阳性率,并比较分析SAA和PCT对诊断细菌性感染的灵敏度、特异度、阳性预测值、阴性预测值和约登指数。结果细菌感染组治疗前SAA和PCT水平均明显高于病毒感染组和健康对照组,且差异具有统计学意义(P<0.05),治疗7d后,SAA和PCT水平均显著下降,且差异具有统计学意义(P<0.05);病毒感染组PCT水平与健康对照组比较,差异无统计学意义(P>0.05),但SAA水平显著高于健康对照组,差异具有统计学意义(P<0.05)。细菌感染组SAA和PCT的阳性率均明显高于病毒感染组和健康对照组,且差异具有统计学意义(P<0.05);病毒感染组PCT的阳性率与健康对照组比较,差异无统计学意义(P>0.05),但SAA的阳性率显著高于健康对照组,差异具有统计学意义(P<0.05)。PCT对诊断学龄前儿童早期细菌性感染的灵敏度、特异度、阳性预测值、阴性预测值分别为92.5%、93.5%、93.9%、92.1%,SAA分别为97.0%、59.7%、72.2%、94.9%,二者的特异度、阳性预测值比较差异有统计学意义(P<0.05)。结论检测SAA和PCT水平有助于学龄前儿童细菌性感染的早期诊断、鉴别诊断和预后判断。Objective To investigate the clinical significance of procalcitonin(PCT)and serum amyloid A(SAA)in early bacterial infection in preschool children.Methods 67 children with bacterial infection(bacterial infection group),62 children with viral infection(viral infection group)and 60 healthy children(healthy control group)were enrolled in this study,latex enhanced turbidimetric immunoassay was used to detect SAA and turbidimetric immunoassay was used to detect the level of PCT,the levels of SAA and PCT and the positive rate were compared among all groups,and the sensitivity,specificity and positive predictive value,negative predictive value and Youden index of SAA and PCT levels.Results The levels of SAA and PCT in the bacterial infection group before treatment were significantly higher than those in the viral infection group and the healthy control group(P<0.05),7 days after treatment,the levels of SAA and PCT decreased significantly(P<0.05);the level of PCT in viral infection group was not significantly different from that in healthy control group(P>0.05),but the positive rate of SAA was significantly different from that of the healthy control group(P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of PCT for early bacterial infection in preschool children were 92.5%,93.5%,93.9%,92.1%,respectively,of the SAA values were 97.0%,59.7%,72.2%and 94.9%,respectively,there were significant differences between the two groups in specificity and positive predictive value(P<0.05).Conclusion Detection of SAA and PCT levels was helpful for early diagnosis,differential diagnosis and prognosis of bacterial infection in preschool children.

关 键 词：降钙素原 血清淀粉样蛋白A 学龄前儿童 早期细菌性感染 

分 类 号：R446.5[医药卫生—诊断学]