急性期反应物在诊断HIV感染儿童急性感染中的作用
Usefulness of acute phase reactants in the diagnosis of acute infections in HIV-infected children.
作者信息
Arango C A, Midani S, Alvarez A, Kubilis P S, Rathore M H
机构信息
Division of Pediatric Infectious Disease/Immunology, University of Florida Health Science Center, Jacksonville, USA.
出版信息
South Med J. 1999 Feb;92(2):209-13. doi: 10.1097/00007611-199902000-00009.
BACKGROUND
Children infected with the human immunodeficiency virus (HIV) often have hypergammaglobulinemia, causing elevation of the erythrocyte sedimentation rate (ESR). This study was done to determine whether C-reactive protein (CRP) is a better indicator of acute infection than ESR in HIV-infected children.
METHODS
Erythrocyte sedimentation rate, CRP, and immunoglobulin G (IgG) levels were measured in sick and otherwise healthy HIV-infected children. McNemar's test was used to compare ESR and CRP.
RESULTS
In 22 of the 26 cases (85%), the IgG level was elevated, and in all cases ESR was elevated. In 20 of these 22 (91%), both ESR and CRP were elevated. Of the 18 controls, 17 (94%) had elevated IgG, 14 of 17 (82%) had elevated ESR, and 1 (7%) had elevated CRP. The sensitivity for ESR and CRP was 96% and 92%, respectively, and the specificity for ESR and CRP was 17% and 94%, respectively.
CONCLUSIONS
Since CRP is more specific than ESR in predicting acute infection in HIV-infected children, it should be used in the evaluation of acute infection in this population.
背景
感染人类免疫缺陷病毒（HIV）的儿童常出现高球蛋白血症，导致红细胞沉降率（ESR）升高。本研究旨在确定在HIV感染儿童中，C反应蛋白（CRP）是否比ESR更能准确反映急性感染。
方法
对患病及健康的HIV感染儿童测量红细胞沉降率、CRP和免疫球蛋白G（IgG）水平。采用McNemar检验比较ESR和CRP。
结果
26例中的22例（85%）IgG水平升高，所有病例ESR均升高。这22例中的20例（91%）ESR和CRP均升高。18例对照中，17例（94%）IgG升高，17例中的14例（82%）ESR升高，1例（7%）CRP升高。ESR和CRP的敏感性分别为96%和92%，特异性分别为17%和94%。
结论
由于CRP在预测HIV感染儿童急性感染方面比ESR更具特异性，因此应将其用于该人群急性感染的评估。
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