CD64指数和血清淀粉样蛋白A检测在学龄前儿童细菌感染诊断和鉴别诊断中的意义
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摘要
目的探讨外周血CD64指数和血清淀粉样蛋白A(SAA)检测在学龄前儿童细菌感染诊断和鉴别诊断中的意义。方法选取50例细菌感染患儿、50例病毒感染患儿和50例健康体检儿童,比较各组CD64、SAA水平及阳性率,并分析CD64、SAA诊断细菌感染的效能。结果细菌感染组外周血CD64指数和SAA水平显著高于病毒感染组和对照组(P<0.05),病毒感染组SAA水平显著高于对照组(P<0.05);经有效抗生素治疗后,细菌感染组CD64和SAA水平均呈明显下降趋势(P<0.05)。CD64诊断细菌感染的敏感度为84.0%、特异度为88.0%、约登指数为0.720,SAA诊断细菌感染的敏感度为94.0%、特异度为32.0%、约登指数为0.260;细菌感染患儿CD64和SAA呈正相关(r=0.791,P<0.05)。结论 CD64和SAA检测在细菌感染的诊断、鉴别诊断和疗效监测中有重要临床价值,且CD64的诊断价值优于SAA。
Objective To explore the significance of detecting peripheral blood CD64 index and serum amyloid A(SAA) in the diagnosis and differential diagnosis of bacterial infection in preschool children. Methods 50 children with bacterial infections, 50 children with viral infections, and 50 healthy children were selected, the levels of CD64 and SAA and the positive rate were compared among the three groups, and the efficacy of CD64 and SAA in diagnosing bacterial infection was analyzed. Results The CD64 index and SAA level in the peripheral blood of the bacterial infection group were significantly higher than those of the viral infection group and the healthy control group(P<0.05). SAA levels in the virus-infected group were significantly higher than those in the healthy control group(P<0.05). After effective antibiotic treatment, the levels of CD64 and SAA in the bacterial infection group showed a significant decrease(P<0.05). The sensitivity of CD64 with bacterial infection was 84.0%, the specificity was 88.0%, the positive predictive value was 87.5%, the negative predictive value was 86.3%, the Youden index was 0.720, and the SAA was 94.0%, 32.0%, 58.0%, 84.2%, 0.260, respectively, and there was a positive correlation between CD64 and SAA in children with bacterial infection(r=0.791, P<0.05). Conclusion The detection of peripheral blood CD64 and serum SAA has important application value in the diagnosis, differential diagnosis and curative effect monitoring of bacterial infection, and the diagnostic value of CD64 is better than SAA.
Objective To explore the significance of detecting peripheral blood CD64 index and serum amyloid A(SAA) in the diagnosis and differential diagnosis of bacterial infection in preschool children. Methods 50 children with bacterial infections, 50 children with viral infections, and 50 healthy children were selected, the levels of CD64 and SAA and the positive rate were compared among the three groups, and the efficacy of CD64 and SAA in diagnosing bacterial infection was analyzed. Results The CD64 index and SAA level in the peripheral blood of the bacterial infection group were significantly higher than those of the viral infection group and the healthy control group(P<0.05). SAA levels in the virus-infected group were significantly higher than those in the healthy control group(P<0.05). After effective antibiotic treatment, the levels of CD64 and SAA in the bacterial infection group showed a significant decrease(P<0.05). The sensitivity of CD64 with bacterial infection was 84.0%, the specificity was 88.0%, the positive predictive value was 87.5%, the negative predictive value was 86.3%, the Youden index was 0.720, and the SAA was 94.0%, 32.0%, 58.0%, 84.2%, 0.260, respectively, and there was a positive correlation between CD64 and SAA in children with bacterial infection(r=0.791, P<0.05). Conclusion The detection of peripheral blood CD64 and serum SAA has important application value in the diagnosis, differential diagnosis and curative effect monitoring of bacterial infection, and the diagnostic value of CD64 is better than SAA.
引文
[1] 吴学朕,刘露,王春晖,等.SAA、CRP及白细胞计数对小儿细菌感染性疾病早期诊断的价值[J].浙江临床医学,2015,17(12):2191-2192.
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[7] 朱锐锋,胡喜梅,周水阳,等.CD64 结合其他炎性指标在细菌感染诊断中的意义[J].中国感染与化疗杂志,2016,16(6):726-729.
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[10] 李攀,阳剑,曹辉彩,等.血清淀粉样蛋白A和C-反应蛋白对儿童支原体肺炎的诊断价值[J].中国医药导报,2017,14(25):134-137.
[11] 高培杰,姚建凤,黄荣富.CD64指数、降钙素原和血清淀粉样蛋白A在学龄前儿童早期细菌感染性腹泻中的临床应用价值[J].实用医技杂志,2017,24(4):365-368.
[12] 石新云,许文芳,陶学芳,等.CD64、降钙素原、血清淀粉样蛋白A及C反应蛋白在急性感染性疾病中的诊断价值[J].国际流行病学传染病学杂志,2017,44(1):38-41.
[13] 李庆,王光海,鞠瑛,等.感染性疾病患者炎性因子水平的表达与意义[J].中华医院感染学杂志,2015,25(12):2649-2651.
[14] 龚菲,刘世国,孔莹,等.SAA和CRP联合检测在小儿感染性疾病鉴别诊断中的应用价值[J].中国微生态学杂志,2015,27(4):429-433.
[15] Elawady S,Boros SK,Sorour AE,et al.Neutrophil CD64 as a diagnostic marker of sepsis in neonates[J].J Investig Med,2014,62(3):644-649.
[16] 吴跃平,王丹,黄娟,等.超敏C-反应蛋白及血清淀粉样蛋白A在儿科感染性疾病中的研究[J].检验医学与临床,2015,12(11):1535-1537.
[2] Farias MG,de Lucena NP,DaI Bo S,et al.Neutmphil cd64 expression as an important diagnostic marker of infection and sepsis in hospitM patients[J].J Immunol Methods,2014,414:65-68.
[3] 田月如,李巍,叶志成,等.血清淀粉样蛋白A和C-反应蛋白检测在儿童感染性疾病诊断中的应用[J].检验医学,2017,32(5):382-385.
[4] 罗国忠,贺海文,杨永成,等.血清淀粉样蛋白A和C-反应蛋白在小儿感染性疾病早期诊断中的价值[J].检验医学与临床,2015,12(22):3368-3370.
[5] 张可琚,陈鸣.中性粒细胞CD64在感染性疾病诊治中的应用[J].中华检验医学杂志,2016,39(5):340-343.
[6] 闫佩毅,张骥,邹玉涵,等.流式细胞术检测CD64 指数及其在诊断细菌感染中的应用[J].检验医学,2017,32(6):514-519.
[7] 朱锐锋,胡喜梅,周水阳,等.CD64 结合其他炎性指标在细菌感染诊断中的意义[J].中国感染与化疗杂志,2016,16(6):726-729.
[8] 林阳,万岁桂.中性粒细胞表面CD64在细菌感染诊断与鉴别诊断中的应用价值[J].标记免疫分析与临床,2014,21(2):111-114.
[9] 费凤英,衣萍,林见敏.血清淀粉样蛋白A与C-反应蛋白联合检测的临床应用价值[J].检验医学,2014,29(10):1031-1033.
[10] 李攀,阳剑,曹辉彩,等.血清淀粉样蛋白A和C-反应蛋白对儿童支原体肺炎的诊断价值[J].中国医药导报,2017,14(25):134-137.
[11] 高培杰,姚建凤,黄荣富.CD64指数、降钙素原和血清淀粉样蛋白A在学龄前儿童早期细菌感染性腹泻中的临床应用价值[J].实用医技杂志,2017,24(4):365-368.
[12] 石新云,许文芳,陶学芳,等.CD64、降钙素原、血清淀粉样蛋白A及C反应蛋白在急性感染性疾病中的诊断价值[J].国际流行病学传染病学杂志,2017,44(1):38-41.
[13] 李庆,王光海,鞠瑛,等.感染性疾病患者炎性因子水平的表达与意义[J].中华医院感染学杂志,2015,25(12):2649-2651.
[14] 龚菲,刘世国,孔莹,等.SAA和CRP联合检测在小儿感染性疾病鉴别诊断中的应用价值[J].中国微生态学杂志,2015,27(4):429-433.
[15] Elawady S,Boros SK,Sorour AE,et al.Neutrophil CD64 as a diagnostic marker of sepsis in neonates[J].J Investig Med,2014,62(3):644-649.
[16] 吴跃平,王丹,黄娟,等.超敏C-反应蛋白及血清淀粉样蛋白A在儿科感染性疾病中的研究[J].检验医学与临床,2015,12(11):1535-1537.