IFN-γ、IL-6和PA检测在鉴别诊断小儿病毒和支原体呼吸道感染中的临床价值  

Clinical Value of detection of IFN-γ,IL-6 and PA in Differential diagnosis of viral and mycoplasma respiratory infections in children

作　　者：李虎 杨春秋[1] 常青[2] 王楠楠 LI Hu;YANG Chun-qiu;CHANG Qing(Department of Laboratory Medicine,Taihe County People's Hospital,Anhui Fuyang 236600)

机构地区：[1]太和县人民医院检验科,安徽阜阳236600 [2]解放军总医院第一医学中心检验科,北京100853

出　　处：《医学检验与临床》2024年第7期1-5,58,共6页Medical Laboratory Science and Clinics

基　　金：国家重点研发计划,项目编号:2021YFC2009300。

摘　　要：目的:探讨伽马干扰素(IFN-γ)、白介素6(IL-6)和前白蛋白(PA)在小儿呼吸道感染鉴别诊断中的临床意义。方法:选取2023年1月-5月本院收治的144例呼吸道感染患儿作为观察组,根据实验室检验结果将其划分为病毒感染组(n=74)和支原体感染组(n=70)。另选取52例同期于本院接受健康查体且检查结果均为正常的儿童作为对照组。比较各组血清IFN-γ、IL-6和PA的水平,分析各检测指标与呼吸道感染的相关性,并绘制ROC曲线评估各指标对小儿呼吸道感染的诊断价值。结果:观察组IFN-γ和IL-6的水平高于对照组,PA水平低于对照组,差异均具有统计学意义(P<0.05)。支原体感染组IFN-γ水平高于病毒感染组,差异均具有统计学意义(P<0.05),IL-6和PA水平两组间差异不具有统计学意义(P0.05)。Spearman相关性分析表明IFN-γ和IL-6与呼吸道感染呈正相关,PA与呼吸道感染呈负相关。ROC分析结果显示,IFN-γ、IL-6和PA三者联合检测诊断病毒性呼吸道感染的灵敏度和特异度分别为94.6%、98.1%,AUC为0.984;三者联合诊断支原体呼吸道感染的灵敏度和特异度分别为91.4%和100%,AUC为0.988。结论:IFN-γ、IL-6和PA水平变化与小儿呼吸道感染关系密切;其中IFN-γ相较于IL-6和PA,在鉴别呼吸道感染类型方面具有较高价值,有利于临床早期鉴别诊断感染类型;IFN-γ、IL-6和PA各指标单独检测在呼吸道感染方面均具有较高的诊断价值,三者联合检测可提高IFN-γ诊断的灵敏度和特异性。Objective:To explore the clinical significance of IFN-γ,IL-6 and PA in differential diagnosis of respiratory tract infection in children.Methods:144 children with respiratory tract infection admitted to our hospital from January 2023 to May 2023 were select as the observation group and were divided into viral infection group(n=74)and mycoplasma infection group(n=70):Besides,52 children who received medical examination at our hospital during the same period and had the normal results were chose as the control group.To compare the IFN-γ,IL-6 and PA level among three groups,analyze the correlation between each index and the respiratory tract infection and draw the ROC curves to evaluate the diagnostic value of each index on respiratory infection of children.Results:IFN-γand IL-6 level of the observation group were higher than those in the control group,and the level ofPA was lower than that of control group;All the differences were statistically significant(P<0.05).Compared with the viral infection group,IFN-γlevel in the mycoplasma infection group was higher,with statistical significance(P<0.05);While IL-6 and PA levels between two group were without statistical difference(P>0.05).Spearman correlation analysis indicated that IFN-γand IL-6 were positively correlated with respiratory tract infection,while PA was negatively correlated.As shown of the ROC analysis results,the sensitivity and specificity of IFN-γ,IL-6 and PA combined detection on viral respiratory tract infection were 94.6%and 98.1%,respectively,and AUC was 0.984.The sensitivity and specificity of the combined diagnosis of mycoplasma respiratory tract infection were 91.4%and 100%,respectively,and AUC was 0.988.Conclusion:The changes of IFN-γ,IL-6 as well as PA levels were closely related to the respiratory infection of children;and compared to the IL-6 and PA,IFN-γhas higher value on differential diagnosis of respiratory infection types,which is conducive to the early diagnosis of infection types in clinic.IFN-γ,IL-6 and PA all have high diagno

关 键 词：呼吸道感染 伽马干扰素 白介素6 前白蛋白 

分 类 号：R446[医药卫生—诊断学] R72[医药卫生—临床医学]