CRP、SAA、血常规联合检测在儿童急性呼吸道感染鉴别诊断中的临床意义  

Study on the application values of C-reactive protein,serum amyloid A and blood routine in pediatric infectious diseases

作　　者：王伟东 张宝予 #高圣翔 翟新月 高悦 王涛[3] WANG Wei-dong;ZHANG Bao-yu;GAO Sheng-xiang(Binzhou Medical University,Shandong Binzhou 256600)

机构地区：[1]滨州医学院,山东滨州256600 [2]宁津县人民医院检验科,山东德州253400 [3]滨州医学院附属医院检验科,山东滨州256600

出　　处：《医学检验与临床》2024年第10期1-6,共6页Medical Laboratory Science and Clinics

基　　金：山东省自然科学基金支持,项目编号:ZR2017PH014。

摘　　要：目的:研究C反应蛋白(C-reactive protein,CRP)、血清淀粉样蛋白A(Serum amyloidA,SAA)、血常规指标中淋巴细胞百分比(Lymphocyteratio,LYM%)和中性粒细胞百分比(Neutrophilratio,NEU%)单独及联合检测在细菌及病毒导致的儿童急性上呼吸道感染鉴别诊断中的临床应用价值。方法:选取本院2022年8月-2023年5月收治的急性上呼吸道感染患儿146例作为研究对象,其中73例病毒感染患儿作为病毒组,73例细菌感染患儿作为细菌组,另选取62例健康体检儿童作为对照组。比较三组CRP、SAA、NEU%、LYM%水平,受试者工作特征曲线(Receiver operating characteristic curve,ROC)模型分析CRP、SAA、NEU%、LYM%单独及CRP、SAA、NEU%联合检测在急性上呼吸道细菌感染类型患儿中的诊断效能,以及CRP、SAA、NEU%、LYM%单独及CRP、SAA、LYM%联合检测在急性上呼吸道病毒感染类型患儿中的诊断效能,并根据ROC曲线下面积(Area under curve,AUC)分析得到最佳截断值,并分析其灵敏度、特异度、阳性预测值和阴性预测值。结果:细菌组的CRP、SAA、NEU%水平均高于对照组(P<0.05),细菌组LYM%水平低于对照组(P<0.05);病毒组CRP、SAA、LYM%水平均高于对照组,病毒组NEU%水平低于对照组(P<0.05)。ROC曲线结果显示,CRP、SAA以及NEU%单独诊断急性上呼吸道细菌感染的AUC值分别为0.722、0.936和0.918,灵敏度分别为0.644、0.904和0.863,特异度分别为0.694和0.871、0.935;CRP、SAA和NEU%联合诊断儿童急性上呼吸道细菌感染的AUC值为0.972,灵敏度为0.959,特异度为0.935。ROC曲线的结果显示,CRP、SAA以及LYM%单独诊断儿童急性上呼吸道病毒感染的AUC值分别为0.708、0.940和0.612,灵敏度分别为0.548、0.932和0.384,特异度分别为0.758、0.823和0.903;CRP、SAA和LYM%联合诊断儿童急性上呼吸道病毒感染的AUC值为0.949,灵敏度为0.959,特异度为0.806。结论:CRP、SAA、血常规NEU%和LYM%检测在儿童急性上呼吸道感染性疾病中有Objective:To study the levels of C-reactive protein(CRP),Serum amyloid A(SAA)and Lymphocyte ratio in blood routine indexes.Clinical value of LYM%and Neutrophil ratio(NEU%)alone and combined detection in differential diagnosis of acute upper respiratory tract infections caused by bacteria and viruses in children.Methods:A total of146 children with acute upper respiratory tract infection admitted to our hospital from August 2022 to May 2023 were selected as the study objects,of which 73 children with viral infection were selected as the viral group,73 children with bacterial infection were selected as the bacterial group,and 62 healthy children with physical examination were selected as the control group.The levels of CRP,SAA,NEU%and LYM%were compared among the three groups.Receiver operating characteristic curve(ROC)model was used to analyze the diagnostic efficacy of CRP,SAA,NEU%and LYM%alone and combined CRP,SAA and NEU%in children with acute upper respiratory tract bacterial infection.And the diagnostic eficacy of CRP,SAA,NEU%and LYM%alone and the combination of CRP,SAA and LYM%in children with acute upper respiratory virus infection.The optimal cut-off value was obtained according to the Area under curve(AUC)analysis.The sensitivity,specificity,positive predictive value and negative predictive value were analyzed.Results:The levels ofCRP,SAA and NEU%in bacteria group were higher than those in control group(P<0.05),and the level of LYM%in bacteria group was lower than that in control group(P<0.05).The levels of CRP,SAA and LYM%in virus group were higher than those in control group,and the levels of NEU%in virus group were lower than those in control group(P<0.05).ROC curve results showed that CRP,SAA and NEU%were independent The AUC values for the diagnosis of acute upper respiratory tract bacterial infection were 0.722,0.936 and 0.918,the sensitivity was 0.644,0.904 and 0.863,and the specificity was 0.694,0.871 and 0.935,respectively.The AUC value,sensitivity and specificity of CRP,SAA and NEU%in the diagnosis

关 键 词：C反应蛋白 血清淀粉样蛋白A 血常规 感染性疾病 

分 类 号：R725.6[医药卫生—儿科] R446.1[医药卫生—临床医学]