摘要
目的分析白细胞(WBC)计数、降钙素原(PCT)、淀粉样蛋白A(SAA)在儿童感染性疾病中的水平变化及其诊断效能。方法选取2023年1月至2024年4月上饶市人民医院收治的60例感染性疾病患儿以及同期的32名健康体检的儿童作为研究对象。60例感染性疾病患儿中,30例为细菌感染者作为细菌感染组,另30例为病毒感染者作为病毒感染组;同期选取的32名健康体检的儿童作为健康对照组。收集细菌感染组与病毒感染组患儿的具体疾病类型,比较三组受检儿童不同时期的WBC计数、PCT、SAA水平,以及WBC计数、PCT、SAA的阳性率。采用受试者工作特征(ROC)曲线分析WBC计数、PCT、SAA单独及联合检测细菌感染的诊断价值。结果细菌感染组患儿中,细菌性肺炎、化脓性扁桃体炎、尿路感染、细菌性痢疾腹泻、脓毒症的例数分别为13例、7例、6例、3例、1例;病毒感染组患儿中,传染单核细胞增多症、淋巴结肿大、龈口炎、肺炎、皮肤疱疹的例数分别为11例、10例、6例、2例、1例。病毒感染组急性期的WBC计数、PCT、SAA水平均低于细菌感染组,PCT、SAA水平均高于健康对照组,差异有统计学意义(P<0.05);细菌感染组急性期的WBC计数、PCT、SAA水平均高于健康对照组,差异有统计学意义(P<0.05)。三组受检儿童恢复期的WBC计数、PCT、SAA水平比较,差异无统计学意义(P>0.05)。病毒感染组的WBC计数与PCT阳性率均低于细菌感染组,SAA阳性率高于健康对照组,差异有统计学意义(P<0.017);细菌感染组的WBC计数、PCT、SAA阳性率均高于健康对照组,差异有统计学意义(P<0.017)。ROC曲线分析结果显示,WBC计数、PCT、SAA联合诊断细菌感染与病毒感染的曲线下方面积(AUC)值均高于上述指标单项诊断,且敏感度及特异度均较高。结论WBC计数、PCT、SAA联合诊断在儿童不同类型的感染性疾病中均具有较高的诊断价值,临床上可检测上述指标的水平变化以期鉴别具体的感染类型,并为患儿病情诊断及预后评估提供指导作用。
Objective To analyze the changes and diagnostic efficacy of white blood cell(WBC)count,procalcitonin(PCT)and amyloid A(SAA)in children with infectious diseases.Methods A total of 60 children with infectious diseases admitted to ShangRao People's Hospital from January 2023 to April 2024 and 32 healthy children during physical examination during the same period were selected as study subjects.Among the 60 children with infectious diseases,30 had bacterial infection as the bacterial infection group,and the other 30 had viral infection as the viral infection group.At the same time,32 healthy children who underwent physical examination were selected as the healthy control group.The specific disease types of children in the bacterial infection group and the viral infection group were collected,and the levels of WBC count,PCT and SAA in the three groups at different periods were compared,as well as the positive rates of WBC count,PCT and SAA.The receiver-operating characteristic(ROC)curve was used to analysis the WBC count,PCT,the diagnostic value of SAA separate and joint detection bacterial infection.Results In the bacterial infection group,the cases of bacterial pneumonia,suppurative tonsillitis,urinary tract infection,bacillary dysentery,diarrhea and sepsis were 13 cases,7 cases,6 cases,3 cases and 1 case,respectively.In the virus infection group,the cases of infectious mononucleosis,lymphadenopathy,gingivitis,pneumonia and skin herpes were 11 cases,10 cases,6 cases,2 cases and 1 case,respectively.The WBC count,PCT and SAA levels in the acute phase of viral infection group were lower than those in the bacterial infection group,and the PCT and SAA levels were higher than those in the healthy control group,and the differences were statistically significant(P<0.05).The WBC count,PCT and SAA levels in the acute phase of bacterial infection group were higher than those in the healthy control group,and the differences were statistically significant(P<0.05).There were no significant differences in WBC count,PCT and SAA levels among the three groups during the recovery period(P>0.05).The positive rate of WBC count and PCT in the virus infection group were lower than those in the bacterial infection group,and the SAA positive rate was higher than that in the healthy control group,and the differences were statistically significant(P<0.017).The positive rate of WBC count,PCT and SAA in bacterial infection group were higher than those in healthy control group,and the differences were statistically significant(P<0.017).The ROC curve analysis showed that the area under curve(AUC)value of the combination of WBC count,PCT and SAA in the diagnosis of bacterial infection and viral infection was higher than those of the above indicators alone,and the sensitivity and specificity were high.Conclusion The WBC count,PCT and SAA combined diagnosis have high diagnostic value in different types of infectious diseases in children.The changes of the above indexes can be detected clinically in order to identify specific infection types and provide guidance for the diagnosis and prognosis evaluation of children.
作者
蒋明义
胡金平
JIANG Mingyi;HU Jinping(Department of Clinical Laboratory,ShangRao People's Hospital,Jiangxi Province,Shangrao 334000,China;Department of Geriatrics,ShangRao People's Hospital,Jiangxi Province,Shangrao 334000,China)
出处
《中国当代医药》
CAS
2024年第23期109-113,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202410958)。
