血清淀粉样蛋白A水平与COVID-19感染患儿疾病严重程度的相关性  

Association of serum amyloid A levels in children with disease severity in children infected with COVID-19

作　　者：赵兰心 赵文静[1] 高小倩[1] 杜池龙 ZHAO Lanxin;ZHAO Wenjing;GAO Xiaoqian;DU Chilong(Department of Pediatrics,Xi′an Central Hospital,Xi′an,Shaanxi 710003,China)

机构地区：[1]西安市中心医院儿科,陕西西安710003

出　　处：《国际检验医学杂志》2025年第9期1035-1040,共6页International Journal of Laboratory Medicine

基　　金：陕西省重点研发计划项目(2017SF-098)。

摘　　要：目的探讨儿童血清淀粉样蛋白A(SAA)水平与新型冠状病毒感染(COVID-19)的患儿疾病严重程度的相关性。方法纳入2022年12月至2023年4月期间该院儿科收治的116例COVID-19感染儿童作为研究对象,根据疾病严重程度分为无症状/轻度组和中/重度组。另外,选择同期接受健康体检的65例健康儿童为对照组。通过酶联免疫吸附试验检测患儿急性期和恢复期血清SAA水平。结果与对照组比较,COVID-19患儿急性期血清SAA水平显著升高(P<0.05)。急性期血清SAA水平识别COVID-19患儿的受试者工作特征(ROC)曲线下面积(AUC)为0.926(95%CI:0.886~0.966)。在COVID-19患儿中,无症状/轻度组和中/重度组患儿急性期血清SAA水平分别为2.71(1.29~10.86)mg/L和37.78(18.58~92.62)mg/L,两组比较,差异有统计学意义(Z=5.782,P<0.001)。此外,经Spearman法分析,急性期血清SAA和COVID-19严重程度呈正相关(r=0.657,P<0.001)。患儿急性期血清SAA水平与C反应蛋白(CRP)、免疫球蛋白(Ig)M、IgG、IgA和中和抗体(NAb)呈显著正相关(P<0.05)。急性期血清SAA水平识别中/重度COVID-19患儿的AUC为0.889(95%CI:0.842~0.955),高于CRP(P<0.05)。与血清抗体(IgM、IgG、IgA和NAb)比较,急性期患儿血清SAA阳性率(≥5.55 mg/L)显著较高(P<0.05)。而恢复期患儿血清SAA阳性率显著低于血清抗体阳性率(P<0.05)。结论急性期血清SAA升高与儿童感染SARS-CoV-2风险和疾病严重程度加重有关。血清SAA有希望成为儿童感染SARS-CoV-2和严重程度监测的良好生物标志物。Objective To investigate the correlation between serum amyloid A(SAA)level and disease severity in children infected with severe acute respiratory syndrome coronavirus 2(COVID-19).Methods A total of 116 children infected with COVID-19 admitted to the Department of Pediatrics of the hospital from December 2022 to April 2023 were included and divided into asymptomatic/mild group and moderate/severe group according to the severity of the disease.In addition,65 healthy children who received health examination during the same period were selected as the control group.Serum SAA levels in children in acute stage and convalescent stage were detected by enzyme-linked immunosorbent assay.Results Compared with the control group,the serum SAA level in the children infected with COVID-19 was significantly increased in the acute stage(P<0.05).The area under the receiver operating characteristic(ROC)curve(AUC)of SAA levels in the acute stage for diagnosing children with COVID-19 infection was 0.926(95%CI:0.886-0.966).In SARS-CoV-2 infected children,the SAA levels in the acute stage in the asymptomatic/mild group and the moderate/severe group were 2.71(1.29-10.86)mg/L and 37.78(18.58-92.62)mg/L,the differences were statistically significant between the two groups(Z=5.782,P<0.001).In addition,serum SAA was positively correlated with severity of SARS-CoV-2 by Spearman analysis(r=0.657,P<0.001).Serum SAA levels were also significantly positively correlated with C-reactive protein(CRP),immunoglobulin(Ig)M,IgG,IgA and neutralizing antibody(NAb)in acute stage(P<0.05).The AUC of serum SAA level in acute stage for diagnosing the moderate/severe children with SARS-CoV-2 was 0.889(95%CI:0.842-0.955),which was higher than that of CRP(P<0.05).Compared with serum antibodies(IgM,IgG,IgA and NAb),the rate of serum SAA positive(≥5.55 mg/L)in children in acute stage was significantly higher(P<0.05).The positive rate of serum SAA in convalescent children was significantly lower than that of serum antibody(P<0.05).Conclusion Elevated serum SAA i

关 键 词：血清淀粉样蛋白A 儿童 新型冠状病毒感染 严重程度 

分 类 号：R725.6[医药卫生—儿科] R563.1[医药卫生—临床医学]