血清淀粉样蛋白A对儿童流感辅助诊断及疗效监测的评价

目的探讨血清淀粉样蛋白A(SAA)对儿童流行性感冒(简称流感)辅助诊断及疗效监测的价值。方法选取2018年8月至2019年7月于该院就诊的1654例流感的患儿为研究对象,其中甲型流感患儿1313例(甲型流感组),乙型流感患儿323例(乙型流感组),同时患甲、乙型流感的患儿18例(混合组),选取同期190例健康儿童作为对照组。回顾性分析并比较4组的血清淀粉样蛋白A(SAA)、C-反应蛋白(CRP)、白细胞计数(WBC)检测结果的差异。结果儿童1~<11岁为感染主要年龄段,4~<7岁感染率最高。2018年8月至2019年3月以甲型流感为主,2019年4-7月以乙型流感为主。在3组流感患儿中,SAA、CRP水平及SAA/CRP均高于对照组(P<0.05),甲型流感患儿SAA、CRP水平及SAA/CRP均高于乙型流感患儿(P<0.05)。流感患儿中SAA的阳性率高于CRP和WBC的阳性率(P<0.05)。32例SAA阳性的患儿流感第一次抗原检测呈阴性,复诊时抗原检测呈阳性。流感患儿治疗后SAA水平低于治疗前(P<0.05)。结论检测SAA水平对提示流感抗原检测假阴性及疗效监测有重要意义。

Evaluation of serum amyloid A for auxiliary diagnosis and curative effect monitoring of influenza in children

Objective To investigate the value of serum amyloid A(SAA)in assisted diagnosis and therapeutic monitoring of influenza in children.Methods A total of 1654 children with influenza who were treated in the hospital from August 2018 to July 2019 were selected as the research objects.Among them,1313 children with influenza A(influenza A group)and 323 children with influenza B(B influenza group),18 children with influenza A and B at the same time(mixed group),with 190 healthy children in the same period as the control group.Retrospectively analyzed and compared the differences in the detection results of serum amyloid A(SAA),C-reactive protein(CRP)and white blood cell count(WBC)in the 4 groups.Results Children aged 1-<11 were the main age groups for infection,and the infection rate was highest among children aged 4-<7.August 2018 to March 2019,influenza A was predominant,and influenza B was predominant in April to July 2019.Among the three groups of children with influenza,SAA,CRP,and SAA/CRP were all higher than those in the control group(P<0.05),and SAA,CRP,and SAA/CRP in children with influenza A were higher than those with influenza B(P<0.05).The positive rate of SAA in children with influenza was higher than that of CRP and WBC(P<0.05).A total of 32 SAA-positive children had a negative influenza antigen test for the first time,and the antigen test was positive at the follow-up visit.The SAA level of children with influenza after treatment was lower than before treatment(P<0.05).Conclusion The detection of SAA level is of great significance for prompting false negative influenza antigen detection and monitoring efficacy.