儿童急性呼吸道感染流行病学及外周血PA、SAA、CRP和PCT变化  

Epidemiological characteristics of children with acute respiratory tract infection and changes of peripheral blood PA,SAA,CRP,and PCT

作　　者：孙潇君 常晓艳 王艳坤 毛雯 王霖 SUN Xiaojun;CHANG Xiaoyan;WANG Yankun;MAO Wen;WANG Lin(Qingdao Haici Hospital(Municipal Traditional Chinese Medicine Hospital)Affiliated with Qingdao University,Qingdao,Shandong 266032,China)

机构地区：[1]青岛大学附属青岛市海慈医院(市中医医院)小儿一科,山东青岛266032 [2]青岛大学附属青岛市海慈医院(市中医医院)肺病一科,山东青岛266032 [3]青岛大学附属青岛市海慈医院(市中医医院)心血管三科,山东青岛266032

出　　处：《中华医院感染学杂志》2025年第5期708-712,共5页Chinese Journal of Nosocomiology

基　　金：山东省中医药科技基金资助项目(M-2022267T)。

摘　　要：目的探究儿童急性呼吸道感染的流行病学及外周血前白蛋白(PA)、血清淀粉样蛋白A(SAA)、C-反应蛋白(CRP)和降钙素原(PCT)变化,为其诊断提供依据。方法将2021年11月-2023年11月青岛大学附属青岛市海慈医院收治的急性呼吸道感染患儿177例及同期健康体检儿童195名分别纳入感染组、健康组。统计感染组病原体检出情况,比较两组PA、SAA、CRP和PCT水平;分析各指标对儿童急性呼吸道感染的诊断价值。结果177例急性呼吸道感染患儿病原体总阳性检出55例(31.07%),其中检出最高的是肺炎支原体(MP)。不同年龄段急性呼吸道感染患儿病原体检出率比较,差异有统计学意义(χ^(2)=8.270,P=0.041),以学龄前期居多。不同季节儿童急性呼吸道感染病原体检出率比较,差异有统计学意义(χ^(2)=9.557,P=0.023),春季、冬季检出率较高。感染组和健康组血清PA、SAA、CRP和PCT水平比较,差异有统计学意义(P<0.05),其中CRP水平感染组为(13.48±4.25)mg/L,健康组为(7.85±2.51)mg/L,差值最大(t=15.724,P<0.001)。四指标联合检测诊断儿童急性呼吸道感染的曲线下面积(AUC)值比其单一AUC值要高(P<0.05)。结论儿童急性呼吸道感染病原体以MP为主,且以学龄前期居多,主要发生于春季、冬季,且其PA、SAA、CRP、PCT表达异常,四指标联合检测对其诊断价值高。OBJECTIVE To explore the epidemiological characteristics of the children with acute respiratory tract infection and analyze the changes of peripheral blood prealbumin(PA),serum amyloid protein A(SAA)and procalcitonin(PCT)so as to provide bases for the clinical diagnosis.METHODS A total of 177 children with acute respiratory tract infection who were treated in Qingdao Haici Hospital Affiliated to Qingdao University from Nov.2021 to Nov.2023 were assigned as the infection group,meanwhile,195 healthy children who received physical examination were chosen as the healthy group.The distribution of pathogens isolated from the patients of the infection group was statistically analyzed.The levels of PA,SAA,CRP and PCT were compared between the two groups.The values of the indexes in diagnosis of the acute respiratory tract infection were analyzed.RESULTS The total positive rate of isolation of pathogens was 31.07%(55/177)among the children with acute respiratory tract infection,and Mycoplasma pneumoniae was the predominant species of pathogen.There was significant difference in the isolation rate of pathogens among the different age groups of children with acute respiratory tract infection(χ^(2)=8.270,P=0.041);the children of the preschool age group were dominant.There was significant difference in the isolation rate of pathogens from the children with acute respiratory tract infection among the different seasons(χ^(2)=9.557,P=0.023);the isolation rates were relatively high in spring and winter.There were significant differences in the levels of serum PA,SAA,CRP and PCT between the infection group and the healthy group(P<0.05);the CRP level was(13.48±4.25)mg/L in the infection group,(7.85±2.51)mg/L in the healthy group,with the difference value maximum(t=15.724,P<0.001).The area under the curve(AUC)value of the joint detection of the four indexes was higher than that of the single detection in diagnosis of the acute respiratory tract infection in the children(P<0.05).CONCLUSIONS M.pneumoniae is dominant among the path

关 键 词：儿童急性呼吸道感染 流行病学 病原菌 前白蛋白 血清淀粉样蛋白A C-反应蛋白 降钙素原 受试者工作特征曲线 诊断价值 

分 类 号：R725.6[医药卫生—儿科]