支原体肺炎患儿治疗前后血清CRP水平、SAA/PCT对疗效的预测效能分析  

The predictive value of serum CRP and SAA/PCT before and after treatment in children with Mycoplasma pneumonia for curative effect

作　　者：吴鹏 夏宏林[1] 赵含信 郝维敏[1] WU Peng;XIA Honglin;ZHAO Hanxin;HAO Weimin(Department of Clinical Laboratory,Suzhou Hospital Affiliated of Anhui Medical University,Suzhou,Anhui 234000,China)

机构地区：[1]安徽医科大学附属宿州医院检验科,安徽宿州234000

出　　处：《国际检验医学杂志》2022年第6期720-725,共6页International Journal of Laboratory Medicine

摘　　要：目的探讨支原体肺炎(MPP)患儿治疗前后C反应蛋白(CRP)水平、血清淀粉样蛋白A(SAA)/降钙素原(PCT)对疗效的预测价值。方法将2019年6月至2020年10月于该院就诊的MPP患儿共114例纳入研究,根据疗效将其分为有效组(92例)与无效组(22例)。比较两组临床资料及治疗前后不同时间点血清CRP水平、SAA/PCT。分析治疗前血清CRP水平、SAA/PCT与临床症状积分、实验室指标的相关性及疗效的影响因素,评价血清CRP水平、SAA/PCT对疗效的预测效能。结果两组病情程度、治疗前临床症状积分、白细胞计数(WBC)、淋巴细胞计数(LYM)比较,差异有统计学意义(P<0.05)。有效组治疗3、5、7 d后血清CRP水平、SAA/PCT低于治疗前及无效组,且治疗3、5、7 d后逐渐降低(P<0.05);无效组治疗3、5、7 d后血清CRP水平、SAA/PCT与治疗前比较差异无统计学意义(P>0.05)。治疗前血清CRP水平(r=0.705、0.595、0.610)、SAA/PCT(r=0.586、0.647、0.720)与WBC、LYM、临床症状积分均呈正相关(P<0.05)。病情程度,治疗前和治疗3、5、7 d后血清CRP水平、SAA/PCT是MPP患儿疗效的影响因素(P<0.05)。受试者工作特征曲线分析显示,治疗前、治疗3、5 d后血清CRP水平、SAA/PCT联合检测预测MPP患儿疗效的价值高于各时间点血清CRP水平、SAA/PCT单独检测(P<0.05)。上述两项指标联合检测预测MPP患儿疗效的曲线下面积由大到小依次为治疗5 d后、治疗3 d后、治疗前(P<0.05)。结论血清CRP水平、SAA/PCT与MPP患儿实验室指标、临床症状相关,治疗期间进行动态监测能有助于疗效预测,能为临床后续治疗提供参考。Objective To investigate the predictive value of C-reactive protein(CRP)levels and serum amyloid A(SAA)/procalcitonin(PCT)levels before and after treatment in children with Mycoplasma pneumonia(MPP).Methods From June 2019 to October 2020,114 children with MPP in our hospital were enrolled in the study and divided into effective group(92 cases)and ineffective group(22 cases)according to the curative effect.The clinical data,serum CRP and SAA/PCT before and after treatment were compared between the two groups.The correlation between serum CRP levels,SAA/PCT and clinical symptom scores,laboratory indicators and influencing factors of curative effect before treatment were analyzed.Results There were statistically significant differences in the severity of disease,clinical symptom scores before treatment,white blood cell count(WBC),lymphocyte count(LYM)between the two groups(P<0.05).After 3,5 and 7 days of treatment,the serum CRP levels and SAA/PCT in the effective group were lower than those before treatment and those in the ineffective group,and decreased in sequence after 3,5 and 7 days of treatment(P<0.05);there was no significant difference in serum CRP levels and SAA/PCT in the ineffective group between before treatment and after 3,5 and 7 days of treatment(P>0.05).Before treatment,serum CRP levels(r=0.705,0.595,0.610),SAA/PCT(r=0.586,0.647,0.720)were positively correlated with WBC,LYM,and clinical symptom scores(P<0.05).The disease severity,serum CRP level and SAA/PCT before treatment and after 3,5 and 7 days of treatment were the influencing factors for the curative effect of children with MPP(P<0.05).ROC curve analysis showed that the value of serum CRP level and SAA/PCT combined prediction before treatment,3 and 5 days after treatment was higher than the two indicators used alone at each time point(P<0.05).The area under the curve of the combined prediction of the above two indicators from large to small were after 5 days of treatment,after 3 days of treatment,and before treatment(P<0.05).Conclusion Serum CR

关 键 词：支原体肺炎 C反应蛋白 淀粉样蛋白A 降钙素原 治疗效果 预测效能 

分 类 号：R446.1[医药卫生—诊断学]