血清淀粉样蛋白A和超敏C反应蛋白在小儿呼吸道感染早期诊断中的应用

目的 分析血清淀粉样蛋白A(serum amyloid A,SAA)和超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)在呼吸道感染患儿血清中的表达水平及其对于疾病早期诊断的应用价值。 方法 筛选杭州市儿童医院儿科2019年3月—2020年3月期间诊治的70例呼吸道感染患儿,纳入研究组,根据病原学检查结果将其分为A组(细菌感染组)与B组(病毒感染组)各35例;另选出同期接受常规体检的35例健康儿童,纳入对照组。研究组患儿于入院初(急性期)与恢复期空腹采集上肢静脉血,对照组儿童一次性采集空腹上肢静脉血,2组均离心处理标本后取血清进行SAA和hs-CRP检测。比较3组儿童SAA和hs-CRP水平,以病原体检测结果为准,分析SAA和hs-CRP早期诊断小儿呼吸道感染的敏感度、特异度、阳性预测值、阴性预测值。 结果 A组与B组患儿入院初的SAA和hs-CRP水平均高于对照组(均P<0.05);A组入院初的SAA和hs-CRP水平与恢复期的SAA水平均高于B组(均P<0.05);A组与B组恢复期的SAA和hs-CRP水平均低于本组入院初(均P<0.05)。SAA和hs-CRP联合检测的敏感度、特异度、阳性预测值、阴性预测值(97.14%、97.14%、97.14%、94.28%)高于SAA单项检测(87.14%、80.00%、89.71%、75.68%)和hs-CRP单项检测(45.71%、68.57%、74.42%、38.71%),均P<0.05。 结论 SAA联合hs-CRP检测在小儿呼吸道感染早期诊断的应用价值高,可为临床诊断提供重要的参考依据。 

Application of serum amyloid A and high sensitivity C-reactive protein in early diagnosis of respiratory tract infection in children

Objective To analyze the expression levels of serum amyloid A(SAA) and high-sensitivity C-reactive protein(hs-CRP) in children with respiratory tract infection and their application value in early diagnosis. Methods Total 70 children with respiratory tract infection diagnosed and treated in our hospital from March 2019 to March 2020 were selected and included in the study group. According to the results of etiological examination, they were divided into group A(bacterial infection group) and group B(viral infection group), and 35 healthy children who received routine physical examination in our hospital at the same time were selected and included in the control group. The venous blood of upper limbs was collected on an empty stomach in the study group at the beginning of admission(acute stage) and recovery period, while the control group was collected once. SAA and hs-CRP were detected. The application value of SAA and hs-CRP in early diagnosis of respiratory tract infection in children was analyzed. Results The levels of SAA and hs-CRP in the group A and B at the beginning of admission were higher than those in the control group(all P<0.05). The levels of SAA and hs-CRP in the group A at the beginning of admission and in the recovery period were higher than those in the group B(all P<0.05). The levels of SAA and hs-CRP in the recovery period in the group A and B were lower than those in the beginning of admission(all P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value of SAA combined with hs-CRP(97.14%, 97.14%, 97.14%, 94.28%) were higher than those of SAA alone(87.14%, 80.00%, 89.71%, 75.68%) and hs-CRP alone(45.71%, 68.57%, 74.42%, 38.71%), all P<0.05. Conclusion SAA combined with hs-CRP detection has high application value in the early diagnosis of respiratory tract infection in children, which can provide important reference for clinical diagnosis and is worth carrying out.