血清淀粉样蛋白 A、C 反应蛋白和降钙素原联合检测在我国儿童呼吸道感染鉴别诊断中的价值。
Value of combined detection of serum amyloid A, C-reactive protein and procalcitonin in differential diagnosis of respiratory tract infection in children of China.
机构信息
Department of Clinical Laboratory, Tianjin Fifth Central Hospital, Tianjin, China.
出版信息
Ann Med. 2022 Dec;54(1):1732-1737. doi: 10.1080/07853890.2022.2064542.
OBJECTIVE
To explore the diagnostic value of combined detection of serum amyloid A (SAA), C-reactive protein (CRP) and procalcitonin (PCT) in children with bacteria or non-bacterial respiratory tract infection.
METHODS
200 children with respiratory tract infections diagnosed in our hospital were included in the study. According to the results of the aetiological examination, they were divided into bacterial infection group and non-bacterial infection group. At the same time, 100 healthy children admitted to the hospital for physical examination during the same period were selected as the healthy subjects control group. Changes in serum SAA, PCT and CRP in three groups were compared. Comparison of a positive rate of the single index and combined detection were performed. Children with bacterial infections were treated with conventional antibiotics. The changes in serum SAA, PCT and CRP in the infection group before and after treatment were compared. The efficacy of SAA, PCT and CRP alone and in combination was compared.
RESULTS
The serum SAA, PCT and CRP levels in the bacterial infection group were higher than those in the non-bacterial infection group and healthy children, and the differences were statistically significant. The positive detection rates and combined detection rates of serum SAA, PCT and CRP in the bacterial infection group were higher than those in the non-bacterial infection group and the healthy subject's control group. After conventional antibiotic treatment, serum SAA, PCT and CR levels in children with bacterial infection were significantly decreased.
CONCLUSION
The combined detection based on SAA, CRP and PCT can effectively identify and diagnose respiratory tract infection in children, providing a certain reference for the promotion of the diagnostic scheme. Key messagesSerum SAA, PCT and CRP were highly expressed in children with respiratory tract infection, and the expression level was the highest in children with bacterial pneumonia.The combined detection of serum SAA, CRP and PCT indicators have higher diagnostic efficiency and can effectively make a differential diagnosis of respiratory tract infection in children.
目的
探讨血清淀粉样蛋白 A（SAA）、C 反应蛋白（CRP）和降钙素原（PCT）联合检测在儿童细菌或非细菌呼吸道感染中的诊断价值。
方法
选取我院收治的呼吸道感染患儿 200 例，根据病原学检查结果分为细菌感染组和非细菌感染组，同时选取同期在我院体检的 100 例健康儿童作为健康对照组，比较三组患儿血清 SAA、PCT、CRP 变化，比较单项指标及联合检测的阳性率，对细菌感染患儿给予常规抗生素治疗，比较感染组患儿治疗前后血清 SAA、PCT、CRP 的变化，比较 SAA、PCT、CRP 单项及联合检测的疗效。
结果
细菌感染组患儿血清 SAA、PCT、CRP 水平高于非细菌感染组和健康对照组，差异有统计学意义；细菌感染组患儿血清 SAA、PCT、CRP 单项及联合检测的阳性检出率和联合检测率均高于非细菌感染组和健康对照组；经常规抗生素治疗后，细菌感染患儿血清 SAA、PCT、CRP 水平均明显降低。
结论
基于 SAA、CRP 和 PCT 的联合检测能有效鉴别和诊断儿童呼吸道感染，为诊断方案的推广提供一定参考。
关键信息
儿童呼吸道感染时血清 SAA、PCT 和 CRP 呈高表达，且细菌性肺炎患儿表达水平最高；血清 SAA、CRP 和 PCT 指标联合检测具有较高的诊断效率，能有效对儿童呼吸道感染进行鉴别诊断。
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