超敏C反应蛋白联合SAA辅助鉴别新冠病毒不同变异株的价值及效能研究  

Study on the diagnostic value and efficacy of hypersensitive C-reactive protein combined with SSA in different SARS-CoV-2 variants

作　　者：李冬梅[1] 杨昌祖 吴南卫 肖华 林永通[1] 林瑶 刘颖 LI Dongmei;YANG Changzu;WU Nanwei;XIAO Hua;LIN Yongtong;LIN Yao;LIU Ying(Sanya Center for Disease Control and Prevention,Sanya,Hainan 572000,China)

机构地区：[1]三亚市疾病预防控制中心检验所,海南三亚572000

出　　处：《中国国境卫生检疫杂志》2024年第2期171-174,共4页Chinese Journal of Frontier Health and Quarantine

摘　　要：目的探讨超敏C反应蛋白(hs-CRP)联合血清淀粉样蛋白A(SAA)对新冠病毒不同变异株辅助鉴别的诊断价值及效能,为临床诊疗提供参考。方法选择2022年2月—2023年4月323例新冠肺炎患者为观察组,采用荧光定量RT-PCR法、第三代Nanopore高通量全基因组序列测定技术完成新冠病毒变异株鉴别;选择同期体检者91人为对照组,用免疫比浊法测定两组hs-CRP水平,用胶乳比浊法测定SAA水平;绘制ROC曲线,分析hs-CRP及SAA辅助诊断新冠病毒不同变异株的效能。结果观察组hs-CRP为(14.51±3.21)mg/L,SAA(19.98±3.25)mg/L,高于对照组(P<0.05);不同性别新冠肺炎患者的hs-CRP及SAA水平差异无统计学意义(P>0.05);年龄≥60岁患者的hs-CRP及SAA水平高于<60岁者(P<0.05)。变异株类型排在前两位的是BA.1和BF.7.14型,分别为63例和56例;新冠肺炎患者均完成变异株鉴定,不同变异株患者的hs-CRP及SAA水平差异有统计学意义(P<0.05),BF.7.14.4型感染者的hs-CRP及SAA水平最高,其次为奥密克戎BA.5.1.3型感染者,而BF.7.14型变异株感染者的hs-CRP[(4.52±0.61)mg/L]及SAA水平[(8.54±0.81)mg/L]最低。ROC曲线表明,hs-CRP联合SAA检测的AUC值为0.875,鉴别新冠病毒不同变异株的灵敏度和特异度高于单一hs-CRP(AUC值为0.735)及SAA水平(AUC值为0.792)(P<0.05)。结论新冠肺炎患者的hs-CRP及SAA水平高于正常值,且不同变异株感染者的水平不同。二者联合测定能提高新冠肺炎的早期诊断和不同病毒变异株的鉴别效能。Objective To explore the auxiliary diagnostic value and efficacy of hypersensitive C-reactive protein(hsCRP)combined with serum amyloid A(SAA)in different SARS-CoV-2 variants,so as to provide reference for clinical diagnosis and treatment.Methods A total of 323 COVID-19 patients from February 2022 to April 2023were selected as the observation group.Fluorescence quantitative RT-PCR and third generation nanopore high-throughput whole genome sequencing technology were used to complete the identification of SARS-CoV-2 variants.91 persons took regular physical examination were selected as the control group.The level of hs-CRP and SAA were measured by using immunoturbidimetry and latex turbidimetry.The ROC curve was drawn to analyze the auxiliary differential diagnostic efficacy of hs-CRP and SAA in different SARS-CoV-2 variants.Results The levels of hs-CRP and SAA of COVID-19 patients in the observation group were(14.51±3.21)mg/L and(19.98±3.25)mg/L,were higher than those in the control group(P<0.05).The levels of hs-CRP and SAA of COVID-19 patients with different genders had no statistical difference(P>0.05).The levels of hs-CRP and SAA in patients aged≥60 years old were higher than those in patients aged<60 years(P<0.05).The top two variant types were BA.1 and BF.7.14,with 63 and 56 cases respectively.All the confirmed COVID-19 cases completed the identification of virus variants,the levels of hs-CRP and SAA of different variants were statistically different(P<0.05).Among them,the patients infected BF.7.14.4 variant had the higher levels of hs-CRP and SAA,followed by BA.5.1.3 variant,while the patients infected BF.7.14 variant had the lower levels of hs-CRP[(4.52±0.61)mg/L]and SAA[(8.54±0.81)mg/L].ROC curve showed that AUC value was 0.875,the sensitivity and specificity of hs-CRP combined with SAA were higher than that of single hs-CRP(AUC value=0.735)and SAA(AUC value=0.792)in different SARS-CoV-2 variants(P<0.05).Conclusion The levels of hs-CRP and SAA were higher than normal in COVID-19 patients,and there w

关 键 词：超敏C反应蛋 血清淀粉样蛋白A 新冠肺炎 新冠病毒 变异株 

分 类 号：R183[医药卫生—流行病学]