床旁检测SAA、hs-CRP和CRP在儿童急性上呼吸道感染疾病诊断中的应用分析

目的采用床旁检测(POCT)急性上呼吸道感染患儿全血血清淀粉样蛋白A(SAA)、超敏C反应蛋白(hs-CRP)、C反应蛋白(CRP)等指标,探讨POCT在儿科急性上呼吸道感染疾病的诊断价值。方法选取该院71例急性上呼吸道感染患儿和对照组,POCT法测定全血SAA、hs-CRP、CRP及白细胞,并作各项指标诊断的ROC曲线,比较其最适界值点(cut off值)、敏感性及特异性。结果急性上呼吸道感染患儿全血SAA、hs-CRP和CRP均比对照组升高,差异有统计学意义(tSAA=6.395,P0.05;ths-CRP=8.516,P0.05;tCRP=3.419,P0.05)。SAA曲线下面积0.830,敏感性69.0%,特异性96.0%;hs-CRP曲线下面积0.823,敏感性81.7%,特异性74.7%。结论采用POCT检测患儿全血SAA、hs-CRP和CRP等炎性指标有助于儿科急性上呼吸道感染疾病的早期诊断和预后判断。其中,SAA和hs-CRP更为敏感。

The clinical diagnosis value judgment of SAA,hs-CRP and CRP with POCT method in pediatric acute upper respiratory ;tract infection disease

Objective To explore the diagnostic value in children with acute upper respiratory tract infection by using bedside diagnosis(POCT) method to detect whole blood level of serum amyloid a protein(SAA) ,hypersensi‐tive C‐reactive protein(hs‐CRP) and C‐reactive protein(CRP) .Methods Analyzed whole blood SAA ,hs‐CRP ,CRP and white blood cell(WBC) in 71 cases of children with acute upper respiratory tract infection and normal control group by using the POCT method ,and compared the cutoff value and sensitivity and specific degrees of each index with ROC curve .Results The level of SAA ,hs‐CRP and CRP in children with acute upper respiratory tract infection were higher than normal control group and their difference all had statistically significance(tSAA =6 .395 ,P<0 .05 ;ths‐CRP =8 .516 ,P<0 .05 ;tCRP =3 .419 ,P<0 .05) .The area under the curve ,sensitivity and specificity of SAA and hs‐CRP were 0 .830 ,0 .823;69 .0% ,81 .7% and 96 .0% ,74 .7% ,respectively .Conclusion Detecting whole blood SAA , hs‐CRP and CRP by POCT method can help the early diagnosis and prognosis of pediatric acute upper respiratory tract infection disease .Among those detection index ,SAA and hs‐CRP is more sensitive .