MxA、CRP和WBC计数鉴别诊断急性呼吸道病毒感染与细菌感染的价值  

Roles of MxA,CRP and WBC count in the differential diagnosis of acute respiratory tract viral and bacterial infections

作　　者：刘春晓 易长林 王小山[3] 朱咏臻 罗安珥 陈长强[2] LIU Chunxiao;YI Changlin;WANG Xiaoshan;ZHU Yongzhen;LUO Aner;CHEN Changqiang(Department of Pediatrics,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201801,China;Department of Clinical Laboratory,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201801,China;Department of Emergency Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201801,China)

机构地区：[1]上海交通大学医学院附属瑞金医院儿内科,上海201801 [2]上海交通大学医学院附属瑞金医院检验科,上海201801 [3]上海交通大学医学院附属瑞金医院急诊内科,上海201801

出　　处：《检验医学》2022年第10期944-947,共4页Laboratory Medicine

基　　金：上海市卫生健康委员会资助项目(20194Y0317);上海交通大学医学院附属瑞金医院(北部)院内课题(2020ZY04)

摘　　要：目的探讨黏病毒抗性蛋白A(MxA)、C反应蛋白(CRP)和白细胞(WBC)计数在急性呼吸道病毒感染与细菌感染鉴别诊断中的应用价值。方法选取急性呼吸道感染性疾病患者594例,其中流感病毒感染350例(病毒感染组)、细菌感染244例(细菌感染组)。另选取体检健康者100名作为正常对照组。检测所有对象的MxA、CRP和WBC计数。采用受试者工作特征(ROC)曲线评价各项指标鉴别诊断呼吸道病毒感染与细菌感染的效能。结果病毒感染组MxA水平显著高于细菌感染组和正常对照组(P<0.05、P<0.01),细菌感染组显著高于正常对照组(P<0.05)。细菌感染组CRP水平和WBC计数显著高于病毒感染组和正常对照组(P<0.05、P<0.01),病毒感染组显著高于正常对照组(P<0.05)。ROC曲线分析结果显示,MxA、CRP和WBC计数单项检测及联合检测模型鉴别诊断呼吸道病毒感染与细菌感染的曲线下面积(AUC)分别为0.829、0.703、0.665、0.850。联合检测模型的鉴别诊断效能优于各项指标单独检测(P<0.01)。结论MxA、CRP和WBC计数在急性呼吸道感染性疾病中具有较好的临床应用价值,MxA在鉴别呼吸道病毒感染和细菌感染中优于CRP和WBC计数,三者联合检测效率更高。Objective To investigate the clinical application values of myxovirus resistance protein A(MxA),C-reactive protein(CRP)and white blood cell(WBC)count in the differential diagnosis of acute respiratory tract viral infection and bacterial infection.Methods The viral infection group(350 cases),bacterial infection group(244 cases)and healthy control group(100 cases)were enrolled for determining MxA,CRP and WBC count.The diagnostic efficacy of the 3 indexes in each group was analyzed by receiver operating characteristic(ROC)curve.Results The MxA level in viral infection group was higher than those in bacterial infection group and healthy control group(P<0.05,P<0.01),and that in bacterial infection group was higher than that in healthy control group(P<0.05).The CRP level and WBC count were higher in bacterial infection group than those in viral infection group and healthy control group(P<0.05,P<0.01),and that in viral infection group was higher than that in healthy control group(P<0.05).ROC curve analysis showed that the areas under curves(AUC)of MxA,CRP,WBC count single determinations and combined determination were 0.829,0.703,0.665 and 0.850 for the differential diagnosis of viral infection and bacterial infection,respectively.The differential diagnostic performance of combined determination was better than those of single determinations(P<0.01).Conclusions MxA,CRP and WBC count have good clinical application value in acute respiratory tract infectious diseases.MxA is superior to CRP and WBC count in distinguishing viral infection and bacterial infection,and the differential diagnostic performance of combined determination is better.

关 键 词：黏病毒抗性蛋白A C反应蛋白 白细胞计数 急性呼吸道感染 

分 类 号：R446.1[医药卫生—诊断学]