SAA联合外周血细胞形态学对小儿病毒性呼吸道感染病情诊断的价值  

Value of serum amyloid A combined with peripheral blood cytomorphology in the diagnosis of pediatric viral respiratory tract infection conditions

作　　者：袁艳军 田二军 张嫚[3] YUAN Yan-jun;TIAN Er-jun;ZHANG Man(Department of Clinical Laboratory,Pingdingshan Maternal and Child Health Hospital,Pingdingshan 467000,Henan,CHINA;Department of Clinical Laboratory,Pingdingshan First People's Hospital,Pingdingshan 467000,Henan,CHINA;Department of Pediatrics,Pingdingshan First People's Hospital,Pingdingshan 467000,Henan,CHINA)

机构地区：[1]平顶山市妇幼保健院检验科,河南平顶山467000 [2]平顶山市第一人民医院检验科,河南平顶山467000 [3]平顶山市第一人民医院儿科,河南平顶山467000

出　　处：《海南医学》2024年第5期704-708,共5页Hainan Medical Journal

基　　金：2020年度河南省医学科技攻关计划联合共建立项项目(编号:LHCJ20200166)。

摘　　要：目的 探讨血清淀粉样蛋白A (SAA)联合外周血细胞形态学对小儿病毒性呼吸道感染病情诊断的特异性及敏感性。方法 按照1∶1比例选取2022年8月至2023年8月平顶山市妇幼保健院收治的122例血常规正常小儿病毒性呼吸道感染患儿(病毒组)及122例健康儿童(对照组)进行前瞻性研究,检测并比较两组儿童外周血细胞形态学(核左移、反应性淋巴细胞比例)改变及SAA水平。统计外周血细胞形态学(核左移、反应性淋巴细胞比例)改变及SAA检出血常规正常小儿病毒性呼吸道感染情况,以病原学诊断结果为金标准,分析外周血细胞形态学改变、SAA及联合检测对小儿病毒性呼吸道感染病情诊断的特异性及敏感性。比较不同病情程度患儿外周血细胞形态学改变及SAA水平,应用Spearman分析外周血细胞形态学改变及SAA水平与病情程度相关性。结果 病毒组儿童的核左移数量、反应性淋巴细胞比例及血清SAA分别为(9.54±3.15)个、(5.94±1.87)%、(29.60±9.53) mg/L,明显高于对照组的(2.27±0.66)个、(0.32±0.20)%、(3.60±0.92) mg/L,差异均有统计学意义(P<0.05);以病原学诊断结果为金标准,外周血细胞形态学改变联合SAA诊断小儿病毒性呼吸道感染的敏感度(98.36%)、特异度(99.18%)、准确率(98.77%)最高,漏诊率(1.64%)最低(P<0.05);重症肺炎儿童的核左移数量、反应性淋巴细胞比例、血清SAA分别为(15.87±5.02)个、(14.26±3.78)%、(47.25±11.33) mg/L,明显高于普通肺炎儿童的(10.61±2.30)个、(5.13±1.54)%、(30.29±8.57) mg/L和上呼吸道感染儿童的(6.09±1.54)个、(6.09±1.54)%、(22.32±4.40) mg/L,而普通肺炎儿童的核左移数量、反应性淋巴细胞比例、血清SAA明显高于上呼吸道感染儿童,差异均有统计学意义(P<0.05);经Spearman分析结果显示,核左移数量、反应性淋巴细胞比例、SAA水平与病情程度均呈正相关(r=0.725、0.801、0.820,P<0.05)。结论 小儿病毒性呼�Objective To investigate the specificity and sensitivity of serum amyloid A(SAA) combined with peripheral blood cytomorphology for the diagnosis of pediatric viral respiratory tract infection conditions.Methods A prospective study was conducted on 122 children with viral respiratory tract infections with normal blood routine test results admitted to Pingdingshan Maternal and Child Health Hospital from August 2022 to August 2023(virus group) and122 healthy children(control group) selected at a ratio of 1:1.The peripheral blood cell morphology(nucleus left shift,reactive lymphocyte ratio) changes and SAA levels were detected and compared between the two groups of children.The diagnostic value of peripheral blood cell morphology(nuclear left shift,reactive lymphocyte ratio) and SAA in children with viral respiratory tract infection with normal blood routine were investigated.Taking the etiological diagnosis as the gold standard,the specificity and sensitivity of peripheral blood cell morphology,SAA,and their combination in the diagnosis of viral respiratory tract infection in children were analyzed.The peripheral blood cell morphology and SAA levels were compared in children with different disease severity,and Spearman's correlation analysis was applied to investigate the correlation between peripheral blood cell morphology and SAA levels and disease severity.Results The number of left-shifted lymphocytes,the proportion of reactive lymphocytes,and the serum SAA level in children with viral infection were(9.54±3.15) cells,(5.94±1.87)%,and(29.60±9.53) mg/L,respectively,which were significantly higher than(2.27±0.66) cells,(0.32±0.20)%,and(3.60±0.92) mg/L in the control group(P<0.05).Using the etiological diagnosis results as the gold standard,the sensitivity(98.36%),specificity(99.18%),and accuracy(98.77%) of peripheral blood cell morphology combined with SAA for the diagnosis of pediatric viral respiratory tract infections were the highest,with the lowest missed diagnosis rate(1.64%),P<0.05.The number of left s

关 键 词：儿童 病毒性呼吸道感染 血常规正常 外周血细胞形态学 血清淀粉样蛋白A 病情程度 

分 类 号：R725.6[医药卫生—儿科]