小儿急性呼吸道感染PA、SAA、CD64、sCD14-ST水平及其诊断价值  

PA,SAA,CD64 and sCD14-ST of children with acute respiratory tract infection and diagnostic values

作　　者：王俭[1] 万光平[1] 李益[1] 朱建松[1] 杜华伟[1] 李阳 张慧 WANG Jian;WAN Guang-ping;LI Yi;ZHU Jian-song;DU Hua-wei;LI Yang;ZHANG Hui(Meishan People's Hospital,Meishan,Sichuan 620010,China)

机构地区：[1]眉山市人民医院儿科,四川眉山620010

出　　处：《中华医院感染学杂志》2023年第23期3659-3663,共5页Chinese Journal of Nosocomiology

基　　金：四川省科研基金资助项目(2021FH369)。

摘　　要：目的探讨前白蛋白(PA)、淀粉样蛋白A(SAA)、CD64、可溶性白细胞分化抗原14亚型(s CD14-ST)与小儿急性呼吸道感染的关系及其诊断价值。方法回顾性选取2019年1月-2022年12月眉山市人民医院儿科收治的498例小儿急性呼吸道感染患儿作为研究组,根据咽拭子细菌培养结果将其分为细菌感染组232例、非细菌感染组266例;另选同期健康体检儿童506名为对照组。采用全自动生化分析仪、胶乳增强免疫比浊法、流式细胞仪、化学发光法分别检测血清PA、SAA、外周血sCD14-ST水平、CD64指数。分析各组临床资料,比较血清PA、SAA、外周血sCD14-ST水平、CD64指数;采用受试者工作特征曲线(ROC)分析血清PA、SAA、外周血sCD14-ST水平、CD64指数单独及联合检测对小儿急性呼吸道感染的诊断价值。结果对照组血清PA水平高于非细菌感染组和细菌感染组(P<0.05),细菌感染组低于非细菌感染组(P<0.05);而对照组血清SAA、外周血sCD14-ST水平、CD64指数低于非细菌感染组和细菌感染组(P<0.05),细菌感染组高于非细菌感染组(P<0.05);绘制ROC曲线获得血清PA、SAA、外周血sCD14-ST水平、CD64指数联合检测诊断小儿急性呼吸道感染的曲线下面积(AUC)为0.934,高于各项单独检测(P<0.05),且联合检测的敏感度和特异度为89.20%,81.40%,诊断价值均较高。结论小儿急性呼吸道感染患儿血清PA水平呈低表达,血清SAA、外周血sCD14-ST水平、CD64指数呈高表达;且血清感染后进一步降低或升高;联合检测血清PA、SAA、外周血sCD14-ST水平、CD64指数有助于诊断小儿急性呼吸道感染。OBJECTIVE To explore the correlation of proalbumin(PA),serumamyloid A(SAA),CD64 and soluble leukocyte differentiation antigen 14 subtype(s CD14-ST)with acute respiratory tract infection in children and its diagnostic value.METHODS A total of 498 children with acute respiratory tract infection admitted to pediatrics department of Meishan City People′s Hospital from Jan 2019 to Dec 2022 were enrolled as the study group.According to the results of bacterial culture of throat swabs,the children were divided into the bacterial infection group(232 cases)and the non-bacterial infection group(266 cases).A total of 506 healthy children in the same period were recruited as the control group.Serum levels of PA,SAA and peripheral blood sCD14-ST and CD64 index were detected by automatic biochemical analyzer,latex enhanced immunoturbidimetry,flow cytometry and chemiluminescence,respectively.Clinical data of each group were analyzed,serum levels of PA,SAA and peripheral blood sCD14-ST and CD64 index were compared among the groups.The diagnostic value of serum levels of PA,SAA and peripheral blood sCD14-ST and CD64 index individual and combined detection in children with acute respiratory tract infection was analyzed by operating characteristic curve(ROC)analysis.RESULTS The serum level of PA in the control group was higher than that in the non-bacterial infection group and bacterial infection group(P<0.05);and that in the bacterial infection group was lower than that in the non-bacterial infection group(P<0.05).The serum levels of SAA and sCD14-ST and CD64 index in peripheral blood of the control group were lower than those of the non-bacterial infection group and bacterial infection group(P<0.05),while those of the bacterial infection group were higher than those of the non-bacterial infection group(P<0.05).ROC curve analysis showed the ara under curve(AUC)of combined detection of serum PA,SAA,peripheral blood sCD14-ST and CD64 index in the diagnosis of children with acute respiratory tract infection was 0.934,which was high

关 键 词：小儿急性呼吸道感染 前白蛋白 淀粉样蛋白A CD64 可溶性白细胞分化抗原14亚型 诊断价值 受试者工作特征曲线 

分 类 号：R725.6[医药卫生—儿科]