摘要
目的探讨血清降钙素原(PCT)、C反应蛋白(CRP)、淀粉样蛋白A(SAA)联合检测对儿童化脓性扁桃体炎的鉴别诊断价值。方法收集123例化脓性扁桃体炎患儿,根据感染病原体不同分为细菌感染组74例,肺炎支原体(MP)感染组29例,病毒感染组20例。比较各组基本资料及PCT、CRP、SAA水平差异,绘制ROC曲线,计算AUC,评价PCT、CRP、SAA对儿童化脓性扁桃体炎的鉴别诊断价值。结果病毒感染组患儿住院天数最长,MP感染组患儿中性粒细胞百分比最高。细菌感染组PCT水平高于MP感染组及病毒感染组(均P<0.01);细菌感染组及MP感染组CRP、SAA水平高于病毒感染组(均P<0.01);PCT、CRP、SAA、PCT+CRP+SAA诊断细菌感染化脓性扁桃体炎的AUC分别为0.780、0.731、0.705、0.871;CRP、SAA诊断MP感染化脓性扁桃体炎的AUC分别为0.933、0.990。结论 PCT+CRP+SAA联合检测可以快速、有效的鉴别诊断儿童化脓性扁桃体炎;CRP、SAA在鉴别MP感染与病毒感染化脓性扁桃体炎时均具有较好的价值,值得推广。
Objective To evaluate the combined detection of serum procalcitonin（PCT）, C-reactive protein（CRP） and amyloid A（SAA） in differential diagnosis of suppurative tonsillitis in children. Methods One hundred and twenty three children with suppurative tonsillitis admitted in our hospital were enrolled. Among 123 patients there were 74 cases with bacterial infection,29 cases with mycoplasma pneumoniae（MP） infection group, and 20 cases with virus infection. The clinical features and the serum PCT, CRP and SAA levels were compared among different groups. The receiver operating characteristic curve（ROC） was plotted and the area under the curve（AUC） was calculated to evaluate the diagnostic value of PCT, CRP and SAA in children with suppurative tonsillitis. Results Children with viral infection had the longest hospital stay, while patients with MP infection had the highest N%（neutrophil cell percentage）（both P〈0.05）. T he level of PCT in bacterial infection group was higher than that in other infection group（P〈0.01）. The serum CRP and SAA levels in bacterial infection and MP infection groups were higher than those in viral infection group（P〈0.01）. The AUC of PCT, CRP, SAA and PCT ＋ CRP ＋ SAA in the diagnosis of bacterial suppurative tonsillitis were 0.780、0.731、0.705 and 0.871, respectively; while the AUC of CRP and SAA in diagnosis of MP or viral suppurative tonsillitis were 0.933 and 0.990, respectively. Conclusion The combined detection of PCT, CRP and SAA can be quickly and effectively in the differential diagnosis of children with suppurative tonsillitis, CRP and SAA have good diagnostic value in the identification of suppurative tonsillitis with MP infection or viral infection.
作者
季孝
刘思宇
史杨
王伟文
JI Xiao;LIU Siyu;SHI Yang(Department of Clinical Laboratory,Lishui Central Hospital,Lishui 323000,China)
出处
《浙江医学》
CAS
2018年第12期1351-1354,共4页
Zhejiang Medical Journal
基金
丽水市科技局重点研发计划项目(2017ZDYF13)
