摘要
目的探讨降钙素原(PCT)、白细胞介素-6(IL-6)、C-反应蛋白(CRP)、血清淀粉样蛋白A(SAA)在儿科急性上呼吸道感染鉴别诊断中的应用。方法采用回顾性研究方法,收集2020年1月-2021年3月徐州医科大学第二附属医院(徐州矿务集团总医院)儿科收治120例感染患儿的临床资料,根据感染类型将患儿分为细菌感染组、病毒感染组、混合感染组,每组各40例;将同期收治的40例非感染疾病患儿作为对照组。采用全自动化学发光分析仪测定所有患儿血清PCT、IL-6、CRP、SAA水平;绘制受试者工作特征曲线(ROC)并计算ROC曲线下面积(AUC),分析并比较各指标单独和联合检测对鉴别儿科急性上呼吸道感染类型的诊断效能。结果细菌感染组PCT、IL-6、CRP水平均明显高于病毒感染组、混合感染组和对照组〔PCT(μg/L):1.54±0.26比0.96±0.32、1.23±0.51、0.28±0.08,IL-6(ng/L):28.60±9.36比16.96±2.34、13.64±6.54、3.94±1.06,CRP(μg/L):2364.36±936.05比1534.69±395.21、1796.52±658.92、337.51±120.69,均P<0.05〕;病毒感染组PCT水平明显低于混合感染组,SAA水平明显高于细菌感染组、混合感染组和对照组〔PCT(μg/L):0.96±0.32比1.23±0.51,SAA(mg/L):71.64±8.73比64.46±13.22、51.77±16.73、7.65±3.69,均P<0.05〕。各指标联合检测鉴别细菌感染和混合感染、细菌感染和病毒感染以及病毒感染和混合感染的AUC均大于单一指标,分别为0.935、0.989、0.873,95%可信区间(95%CI)分别为0.886~0.984、0.973~1.000、0.797~0.950。结论PCT、IL-6、CRP、SAA在儿科急性上呼吸道感染诊断及相关感染类型鉴别中均有一定临床意义,多指标联合检测可为儿科上呼吸道感染的早期诊疗提供参考。
Objective To explore the application of procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein(CRP)and serum amyloid A(SAA)in the differential diagnosis of pediatric acute upper respiratory tract infection.Methods A retrospective research model was adopted.From January 2017 to March 2018,the clinical data of 120 pediatric infected patients in the Second Affiliated Hospital of Xuzhou Medical College,General Hospital of Xuzhou Mining Group were collected.According to the type of infection,they were divided into bacterial infection group,viral infection group and mixed infection group,with 40 cases in each group.In the same period,40 children with non-infectious disease were as the control group.The serum PCT,IL-6,CRP,SAA levels were measured by automatic chemiluminescence analyzer.Receiver operator characteristic curve(ROC)was drawn,area under curve(AUC)was calculated,and the diagnostic efficacies of individual and combined detection of each index in identifying pediatric acute upper respiratory tract infection were analyzed and compared.Results The levels of PCT,IL-6 and CRP in bacterial infection group were higher than those in viral infection group,mixed infection group and control group[PCT(μg/L):1.54±0.26 vs.0.96±0.32,1.23±0.51,0.28±0.08,IL-6(ng/L):28.60±9.36 vs.16.96±2.34,13.64±6.54,3.94±1.06,CRP(μg/L):2364.36±936.05 vs.1534.69±395.21,1796.52±658.92,337.51±120.69,all P<0.05].In viral infection group,the PCT level was lower than that in mixed infection group,and the SAA level was higher than those in bacterial infection group,mixed infection group and control group[PCT(μg/L):0.96±0.32 vs.1.23±0.51,SAA(mg/L):71.64±8.73 vs.64.46±13.22,51.77±16.73,7.65±3.69,all P<0.05].The AUC of combined detection in distinguishing bacterial infection from mixed infection,bacterial infection from viral infection and viral infection from mixed infection were larger than single indexes,which were 0.935,0.989 and 0.873,respectively,and the 95%confidence interval(95%CI)was 0.886-0.984,0.973-1.000 and 0.797-0.950,respectively.Conclusion The levels of PCT,IL-6,CRP and SAA have certain clinical significance in the diagnosis of pediatric acute upper respiratory tract infection and the differential diagnosis of related infection types.The multi index joint detection can provide reference for the early diagnosis and treatment of clinical pediatric acute upper respiratory tract infection.
作者
韩卫
赵亚琦
张晓彤
Han Wei;Zhao Yaqi;Zhang Xiaotong(Department of Blood Transfusion,the Second Affiliated Hospital of Xuzhou Medical College,General Hospital of Xuzhou Mining Group,Xuzhou 221006,Jiangsu,China;Department of Clinical Laboratory,the Second Affiliated Hospital of Xuzhou Medical College,General Hospital of Xuzhou Mining Group,Xuzhou 221006,Jiangsu,China)
出处
《实用检验医师杂志》
2021年第3期133-136,共4页
Chinese Journal of Clinical Pathologist
