SAA、PCT、CRP及SAA/PCT比值对婴幼儿感染性疾病的诊断价值
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摘要
目的分析血清淀粉样蛋白A(serum amyloid A protein,SAA)、降钙素原(procalcitonin,PCT)、C反应蛋白(C reactiveprotein,CRP)及SAA/PCT比值对婴幼儿感染性疾病的诊断价值,为临床快速准确诊断婴幼儿感染性疾病提供理论依据。方法选取2017年1月至2018年1月于海军军医大学长海医院儿科就诊的发热婴幼儿586例纳入观察组,再根据感染类型将其分为病毒感染组(210例)、细菌感染组(318例)及支原体感染组(58例)。另选取该院同期体检的无发热且健康的婴幼儿356例纳入对照组。检测观察组和对照组婴幼儿血液中SAA、PCT及CRP水平,并计算SAA/PCT比值,分析各项指标对婴幼儿病毒性感染和细菌性感染的诊断效能。结果 PCT诊断细菌感染的ROC曲线下面积最大(0.819),当诊断截点为0.533 mmol/L时,其敏感度为0.584,特异度为0.936。SAA/PCT比值诊断病毒感染的ROC曲线下面积最大(0.744),当SAA/PCT比值诊断截点为118.3时,敏感度为0.882,特异度为0.566。结论 SAA/PCT比值对病毒感染的诊断效能最高,PCT对细菌感染的诊断效能最高。
Objective To analyze the diagnostic value of serum amyloid A protein(SAA), procalcitonin(PCT), C reactive protein(CRP) and SAA/PCT ratio in infants and children with infectious diseases and to provides a theoretical basis for the rapid and accurate diagnosis of infectious diseases in infants and children. Method From January 2017 to January 2018, 586 febrile infants and children who were treated in Changhai Hospital were selected for inclusion in observation group. According to the type of infection, they were divided into virus infection group(210 cases), bacterial infection group(318 cases) and mycoplasma infection group(58 cases). In addition, 356 healthy infants without fever were selected as control group. The levels of SAA, PCT and CRP in observation group and control group were measured, and SAA/PCT ratio was calculated, and to analyze the diagnostic efficiency of each index for viral infection and bacterial infection in infants and children. Result The area under the ROC curve of PCT for the diagnosis of bacterial infection was the largest(0.819), when the diagnostic cut-off point was 0.533 mmol/L, the sensitivity and specificity were 0.584 and 0.936 respectively. The area under the ROC curve of SAA/PCT ratio was the largest(0.744), when the cut-off point of SAA/PCT diagnosis was 118.3, the sensitivity was 0.882 and the specificity was 0.566. Conclusion The SAA/PCT ratio is the most effective in the diagnosis of viral infection, and PCT is the most effective in the diagnosis of bacterial infection.
Objective To analyze the diagnostic value of serum amyloid A protein(SAA), procalcitonin(PCT), C reactive protein(CRP) and SAA/PCT ratio in infants and children with infectious diseases and to provides a theoretical basis for the rapid and accurate diagnosis of infectious diseases in infants and children. Method From January 2017 to January 2018, 586 febrile infants and children who were treated in Changhai Hospital were selected for inclusion in observation group. According to the type of infection, they were divided into virus infection group(210 cases), bacterial infection group(318 cases) and mycoplasma infection group(58 cases). In addition, 356 healthy infants without fever were selected as control group. The levels of SAA, PCT and CRP in observation group and control group were measured, and SAA/PCT ratio was calculated, and to analyze the diagnostic efficiency of each index for viral infection and bacterial infection in infants and children. Result The area under the ROC curve of PCT for the diagnosis of bacterial infection was the largest(0.819), when the diagnostic cut-off point was 0.533 mmol/L, the sensitivity and specificity were 0.584 and 0.936 respectively. The area under the ROC curve of SAA/PCT ratio was the largest(0.744), when the cut-off point of SAA/PCT diagnosis was 118.3, the sensitivity was 0.882 and the specificity was 0.566. Conclusion The SAA/PCT ratio is the most effective in the diagnosis of viral infection, and PCT is the most effective in the diagnosis of bacterial infection.
引文
[1]季孝,刘思宇.降钙素原、C-反应蛋白、血清淀粉样蛋白A联合检测对婴幼儿细菌感染性疾病早期诊断的价值[J].中国卫生检验杂志,2018,28(8):967-969.
[2]马国瑞.血清降钙素原检测在小儿危急症感染诊断中的意义研究[J].中国临床医生杂志,2017,45(8):103-105.
[3]夏小兰,马露,崔倪.孟鲁司特钠治疗小儿呼吸道合胞病毒感染毛细支气管炎的疗效及对血清Cys LTs、ECP水平的影响[J].中国医学前沿杂志(电子版),2018,10(11):24-27.
[4]朱星成,段勇,黄革联,等.PCT、hs-CRP、SAA对细菌与病毒感染的鉴别作用[J].国际检验医学杂志,2014,35(22):3048-3050.
[5]吴金斌,邹德学,周逵,等.降钙素原与淀粉样蛋白A检测在学龄前儿童早期细菌感染中的诊断价值[J].国际检验医学杂志,2016,37(15):2126-2128.
[6]Plesko M,Suvada J,Makohusova M,et al.The role of CRP,PCT,IL-6 and presepsin in early diagnosis of bacterial infectious complications in paediatric haemato-oncological patients[J].Neoplasma,2016,63(5):752-760.
[7]Plesko M,Suvada J,Makohusova M,et al.The role of CRP,PCT,IL-6 and presepsin in early diagnosis of bacterial infec tious complications in paediatric haemato-oncological patients[J].Neoplasma,2016,63(5):752-760.
[8]Qu J,Xiaoju L,Liu Y,et al.Evaluation of procalcitonin,C-reactive protein,interleukin-6&serum amyloid A as diagnostic biomarkers of bacterial infection in febrile patients[J].Indian J Med Res,2015,141(3):315-321.
[9]Quadir AF,Britton PN.Procalcitonin and C-reactive protein as biomarkers for neonatal bacterial infection[J].J Paediatr Child Health,2018,54(6):695-699.
[10]何勤,樊省廉,韦丽仁.动态监测肺部感染相关脓毒症患儿血清降钙素原水平的临床意义[J].中国医刊,2015,50(8):102-104.
[11]张晓艳,崔红,杨爱君,等.新生儿呼吸道合胞病毒下呼吸道感染临床分析[J].中国医刊,2016,51(7):64-67.
[12]白涛敏,张西嫔,卫丽.血清心肌肌钙蛋白、丙二醛及超氧化物歧化酶在病毒性心肌炎患儿临床诊治中的价值分析[J].中国临床医生杂志,2017,45(12):100-103.
[13]赵秋剑,高海峰,乔正梅,等.小儿上呼吸道感染高敏C反应蛋白表达水平的研究[J].中国医学前沿杂志(电子版),2016,8(3):53-55.
[14]Hatipoglu M,Gozdas HT.The role of procalcitonin in febrile patients[J].Indian Indian J Med Res,2015,142(3):346.
[15]张爱明,郑梅.血常规、CRP和PCT在婴幼儿感染性疾病早期诊断中的临床价值[J].现代中西医结合杂志,2015,24(2):187-188.
[16]陈俞余,熊建琼.降钙素原、白介素-6及淋巴细胞亚群对脓毒症病情严重程度及预后的评估价值[J].中国医学前沿杂志(电子版),2017,9(2):128-132.
[17]翟洪波.C-反应蛋白联合血常规检测在新生儿支气管感染性疾病中的临床诊断价值[J].世界最新医学信息文摘,2015,15(10):33,47.
[18]余蓓蓓,肖冰,金琳,等.C反应蛋白和降钙素原检测在诊断早期宫内感染中的意义分析[J].中国医学前沿杂志(电子版),2014,6(11):67-70.
[19]赵秋剑,高海峰,乔正梅,等.小儿上呼吸道感染高敏C反应蛋白表达水平的研究[J].中国医学前沿杂志(电子版),2016,8(3):53-55.
[20]梁结玲,罗标,江跃武,等.血清淀粉样蛋白A和超敏C反应蛋白联合检测在小儿呼吸道感染性疾病早期鉴别诊断中的应用价值[J].中国当代医药,2018,25(36):130-133.
[21]陆居文,温成波,刘琼章,等.血清淀粉样蛋白A和C-反应蛋白联合检测在小儿感染性疾病鉴别诊断中的应用价值[J].中国当代医药,2018,25(30):116-118.
[2]马国瑞.血清降钙素原检测在小儿危急症感染诊断中的意义研究[J].中国临床医生杂志,2017,45(8):103-105.
[3]夏小兰,马露,崔倪.孟鲁司特钠治疗小儿呼吸道合胞病毒感染毛细支气管炎的疗效及对血清Cys LTs、ECP水平的影响[J].中国医学前沿杂志(电子版),2018,10(11):24-27.
[4]朱星成,段勇,黄革联,等.PCT、hs-CRP、SAA对细菌与病毒感染的鉴别作用[J].国际检验医学杂志,2014,35(22):3048-3050.
[5]吴金斌,邹德学,周逵,等.降钙素原与淀粉样蛋白A检测在学龄前儿童早期细菌感染中的诊断价值[J].国际检验医学杂志,2016,37(15):2126-2128.
[6]Plesko M,Suvada J,Makohusova M,et al.The role of CRP,PCT,IL-6 and presepsin in early diagnosis of bacterial infectious complications in paediatric haemato-oncological patients[J].Neoplasma,2016,63(5):752-760.
[7]Plesko M,Suvada J,Makohusova M,et al.The role of CRP,PCT,IL-6 and presepsin in early diagnosis of bacterial infec tious complications in paediatric haemato-oncological patients[J].Neoplasma,2016,63(5):752-760.
[8]Qu J,Xiaoju L,Liu Y,et al.Evaluation of procalcitonin,C-reactive protein,interleukin-6&serum amyloid A as diagnostic biomarkers of bacterial infection in febrile patients[J].Indian J Med Res,2015,141(3):315-321.
[9]Quadir AF,Britton PN.Procalcitonin and C-reactive protein as biomarkers for neonatal bacterial infection[J].J Paediatr Child Health,2018,54(6):695-699.
[10]何勤,樊省廉,韦丽仁.动态监测肺部感染相关脓毒症患儿血清降钙素原水平的临床意义[J].中国医刊,2015,50(8):102-104.
[11]张晓艳,崔红,杨爱君,等.新生儿呼吸道合胞病毒下呼吸道感染临床分析[J].中国医刊,2016,51(7):64-67.
[12]白涛敏,张西嫔,卫丽.血清心肌肌钙蛋白、丙二醛及超氧化物歧化酶在病毒性心肌炎患儿临床诊治中的价值分析[J].中国临床医生杂志,2017,45(12):100-103.
[13]赵秋剑,高海峰,乔正梅,等.小儿上呼吸道感染高敏C反应蛋白表达水平的研究[J].中国医学前沿杂志(电子版),2016,8(3):53-55.
[14]Hatipoglu M,Gozdas HT.The role of procalcitonin in febrile patients[J].Indian Indian J Med Res,2015,142(3):346.
[15]张爱明,郑梅.血常规、CRP和PCT在婴幼儿感染性疾病早期诊断中的临床价值[J].现代中西医结合杂志,2015,24(2):187-188.
[16]陈俞余,熊建琼.降钙素原、白介素-6及淋巴细胞亚群对脓毒症病情严重程度及预后的评估价值[J].中国医学前沿杂志(电子版),2017,9(2):128-132.
[17]翟洪波.C-反应蛋白联合血常规检测在新生儿支气管感染性疾病中的临床诊断价值[J].世界最新医学信息文摘,2015,15(10):33,47.
[18]余蓓蓓,肖冰,金琳,等.C反应蛋白和降钙素原检测在诊断早期宫内感染中的意义分析[J].中国医学前沿杂志(电子版),2014,6(11):67-70.
[19]赵秋剑,高海峰,乔正梅,等.小儿上呼吸道感染高敏C反应蛋白表达水平的研究[J].中国医学前沿杂志(电子版),2016,8(3):53-55.
[20]梁结玲,罗标,江跃武,等.血清淀粉样蛋白A和超敏C反应蛋白联合检测在小儿呼吸道感染性疾病早期鉴别诊断中的应用价值[J].中国当代医药,2018,25(36):130-133.
[21]陆居文,温成波,刘琼章,等.血清淀粉样蛋白A和C-反应蛋白联合检测在小儿感染性疾病鉴别诊断中的应用价值[J].中国当代医药,2018,25(30):116-118.