摘要
目的 探讨儿童急性呼吸道感染者血前白蛋白(PA)、血清胰石蛋白(PSP)、免疫球蛋白G Fc段受体I(CD64)、可溶性白细胞分化抗原14亚型(sCD14-ST)的变化及其临床诊断价值。方法 回顾性选取2019年9月至2023年3月眉山市四所医院收治的498例儿童急性呼吸道感染患儿作为研究组,根据咽拭子细菌培养结果将其分为细菌感染组232例和非细菌感染组266例;另选取同期体检的健康儿童506例作为对照组。检测所有儿童的血清PA、PSP、外周血sCD14-ST水平、CD64指数。比较三组儿童的临床资料,同时比较研究组和对照组以及细菌感染组和非细菌感染组患儿的血清PA、PSP、外周血sCD14-ST水平、CD64指数;采用受试者工作特征曲线(ROC)分析血清PA、PSP、外周血sCD14-ST水平、CD64指数单独及联合检测对儿童急性呼吸道感染的诊断价值。结果 研究组患儿的血清PA水平明显低于对照组,而血清PSP、外周血sCD14-ST水平、CD64指数则明显高于对照组,差异均有统计学意义(P<0.05);细菌感染组患儿的血清PA水平明显低于非细菌感染组,而血清PSP、外周血sCD14-ST水平、CD64指数则明显高于非细菌感染组,差异均有统计学意义(P<0.05);绘制ROC获得血清PA、PSP、外周血sCD14-ST水平、CD64指数单独及联合检测诊断儿童急性呼吸道感染患儿的AUC分别为0.885、0.780、0.818、0.848、0.934。其中,联合诊断的AUC高于各项单独检测(P<0.05),且联合检测的敏感度和特异度为89.20%,81.40%,诊断价值均较高。结论 儿童急性呼吸道感染者血清PA水平呈低表达,血清PSP、外周血sCD14-ST水平、CD64指数呈高表达;且细菌感染较非细菌感染的儿童急性呼吸道感染患儿血清PA水平降低,而血清PSP、外周血sCD14-ST水平和CD64指数则升高;联合检测血清PA、PSP、外周血sCD14-ST水平、CD64指数有助于诊断儿童急性呼吸道感染。
Objective To investigate the changes and clinical diagnostic value of prealbumin(PA),pancreatic stone protein(PSP),CD64,and soluble leukocyte differentiation antigen 14 subtype(sCD14-ST) in children with acute respiratory tract infections.Methods A total of 498 children with acute respiratory tract infection admitted to four hospitals in Meishan from September 2019 to March 2023 were retrospectively selected as the study group.According to the results of bacterial culture of throat swabs,they were divided into bacterial infection group(n=232) and non-bacterial infection group(n=266).The clinical data of 506 healthy children in the same period were selected as the control group.Serum PA,PSP,sCD14-ST levels in peripheral blood and CD64 index were measured.The clinical data of each group were analyzed,and the serum PA,PSP,peripheral blood s CD14-ST levels,CD64 index,serum PA,PSP,peripheral blood sCD14-ST levels,and CD64 index were compared between the study group and the control group.The diagnostic value of serum PA,PSP,peripheral blood sCD14-ST levels,CD64 index alone and in combination for acute respiratory tract infection in children was analyzed using a receiver operating characteristic curve(ROC) to guide clinical application.Results The serum PA levels in the study group were significantly lower than those in the control group,while the serum PSP,peripheral blood s CD14-ST levels,and CD64 index were significantly higher than those in the control group,with statistically significant differences(P<0.05).The serum PA levels in the bacterial infection group were significantly lower than those in the non-bacterial infection group,while the serum PSP,peripheral blood sCD14-ST levels,and CD64 index were significantly higher than those in the non-bacterial infection group,with statistically significant differences(P<0.05).The AUC of serum PA,PSP,peripheral blood sCD14-ST level,and CD64 index alone and in combination in the diagnosis of acute respiratory tract infection in children was 0.885,0.780,0.818,0.848,and 0.934,respectively.Among them,the AUC of combined detection was higher than that of each index alone(P<0.05),and the sensitivity and specificity of combined detection were 89.20% and 81.40%,respectively,with high diagnostic value was high.Conclusion Serum PA level is lowly expressed,and serum PSP,sCD14-ST level,and CD64 index are highly expressed in children with acute respiratory tract infection.serum PA level is decreased,while serum PSP,sCD14-ST level,and CD64 index are increased in children with bacterial infection compared with children without bacterial infection.Combined detection of serum PA,PSP,s CD14-ST level,and CD64 index in peripheral blood is helpful for the diagnosis of acute respiratory tract infection in children.
作者
王俭
胡林兵
罗宁
徐华英
冯小平
WANG Jian;HU Lin-bing;LUO Ning;XU Hua-ying;FENG Xiao-ping(Department of Pediatrics,Meishan People's Hospital,Meishan 620010,Sichuan,CHINA;Department of Pediatrics,Hongya County People's Hospital,Meishan 620010,Sichuan,CHINA;Department of Pediatrics,Renshou County People's Hospital,Meishan 620010,Sichuan,CHINA;Department of Pediatrics,Qingshen County People's Hospital,Meishan 620010,Sichuan,CHINA)
出处
《海南医学》
CAS
2024年第5期694-698,共5页
Hainan Medical Journal
基金
2023年四川省眉山市科技局项目(编号:2023KJZD012)。
