[1]罗 强,刘振杰,徐 宁,等.联合检测SAA,hs-CRP,PCT和WBC在广东地区不同年龄人群感染患者诊断价值的多中心分析[J].现代检验医学杂志,2015,30(04):39-42.[doi:10.3969/j.issn.1671-7414.2015.04.010]
　LUO Qiang,LIU Zhen-jie,XU Ning,et al.Multicenter Study on Serum Amyloid A Protein, High-Sensitivity C-Reactive Protein and Procalcitonin in Combining Diagnosis of Infection in Different Population from Guangdong[J].Journal of Modern Laboratory Medicine,2015,30(04):39-42.[doi:10.3969/j.issn.1671-7414.2015.04.010]
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联合检测SAA,hs-CRP,PCT和WBC在广东地区不同年龄人群感染患者诊断价值的多中心分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第30卷
期数:
2015年04期
页码:
39-42
栏目:
论著
出版日期:
2015-08-10

文章信息/Info

Title:
Multicenter Study on Serum Amyloid A Protein, High-Sensitivity C-Reactive Protein and Procalcitonin in Combining Diagnosis of Infection in Different Population from Guangdong
文章编号:
1671-7414(2015)04-039-04
作者:
罗 强1; 刘振杰1; 徐 宁1; 张伟红2; 黄艳芬3; 马东理4; 张 鹏5; 龙 燕6; 吴学朕7; 薛雄燕8
1.广东省中医院检验科,广州 510370;
2.广州市第一人民医院检验科,广州 510180;
3.广东省妇幼保健院检验科,广州 510010;
4.深圳市儿童医院检验科,广东深圳518038;
5.南方医科大学南方医院检验科,广州 510515;
6.广州市妇婴医院检验科,广州510180;
7.惠州市人民医院检验科,广东惠州 516001;
8.佛山市第一人民医院检验科,广东佛山 528000
Author(s):
LUO Qiang1; LIU Zhen-jie1; XU Ning1; ZHANG Wei-hong2;  HUANG Yan-fen3; MA Dong-li4; ZHANG Peng5; LONG Yan6; WU Xue-zhen7; XUE Xiong-yan8
1.Department of Laboratory Medicine,Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510370,China;
2.Department of Laboratory Medicine,the First People's Hospital of Guangzhou City,Guangzhou 510180,China;
3.Department of Laboratory M
关键词:
血清淀粉样蛋白A;  超敏C反应蛋白;  降钙素原;  多中心研究
分类号:
R392.11
DOI:
10.3969/j.issn.1671-7414.2015.04.010
文献标志码:
A
摘要:
目的 通过对广东地区8家三甲医院的2 459例受试对象的血清淀粉样蛋白A(SAA),超敏C反应蛋白(hs-CRP)和降钙素原(PCT)检测数据进行多中心分析,探讨联合检测三个参数在不同人群感染中的诊断效力。方法 受试对象按照年龄和感染类型分组,通过SAA和hs-CRP的年龄趋势性分析、年龄组间病毒和细菌感染组的配对t检验,通过ROC曲线和参数进行3个指标的感染判断效率分析,感染病原判断的二元Logistic回归分析以及与细菌培养在阳性感染判断吻合性分析,确认联合诊断效力。结果 SAA和hs-CRP在低龄阶段的病毒和细菌组差异有统计学意义(P＜0.001); 低龄组SAA的AUC最高为0.824,敏感度71.8%,特异度82.6%,高龄组hs-CRP的AUC最高为0.806,敏感度84%,特异度65.1%; 在低龄组能鉴别诊断细菌和病毒感染的准确率可达到78.8%,而高年龄组只达到65.1%; 对细菌培养阳性病例的判断SAA的AUC最高为0.883,敏感度只有71.2%,但特异度达到90.7%,鉴别诊断准确率达到95.2%。结论 SAA和hs-CRP有明显的年龄趋势,SAA,hs-CRP和PCT 3个指标可单独和联合用于感染鉴别诊断,尤其是对低年龄人群有价值,SAA是单独鉴别诊断最好的指标,SAA/hs-CRP比值作为感染诊断指标的价值不大。
Abstract:
Objective To evaluate combined effect on different population through 2 459 data of SAA,hs-CRP and PCT from 8 three-level hospitals in Guangdong region.Methods Subjects were divided into five groups by ages,and every group had bacterial and virus type.In order to confirm diagnostic effect on infection,methods were performed including in tendency of SAA and hs-CRP,Paired t test between bacterial and virus group,efficiency of 3 indexes in judging infection depending on ROC and parameters,multiple logistic regression,consistency between positive bacterial infectionand bacterial culture.Results There were statisticallysignificant differences in SAA and hs-CRP between bacterial and virus in infants and children(P＜0.001).SAA had the biggest AUC area 0.824 with sensibility 71.8% and specificity 82.6% in younger group.Corresponding,hs-CRP had the biggest area 0.806 with sensibility 84%.There was the accuracy of 78.8% fordifferential diagnosis in younger group,while 65.1% in elder group.AUC of SAA was 0.883 for positive bacterial culture with sensibility 71.2% and specificity 90.7%,accuracy of 95.2% for differential diagnosis.ConclusionThere was obvious trend of age in SAA and hs-CRP,3 indexes couldbe used for differential diagnosis alone or combined,especially in younger group.SAA is the best index as a separated index.There is less value at ratio of SAA and hs-CRP.

参考文献/References:

[1] Yuan HN,Huang J,Lu BK,et al.Diagnosis value of the serum amyloid a test in neonatal sepsis:a meta-analysis[J].Biomed Research International,2013(2013):520294.
[2] dos Anjos BL, Grotto HZ. Evaluation of C-reactive protein and serum amyloid A in the detection of inflammatory and infectious diseases in children[J].Clin Chem Lab Med,2010,48(4):493-499.
[3] Cetinkaya M,Ozkan H,K(¨overo)ksal N,et al.Comparison of serum amyloid A concentrations with those of C-reactive protein and procalcitonin in diagnosis and follow-up of neonatal sepsis in premature infants[J].J Perinatol,2009,29(3):225-231.
[4] 耿红莲,仲人前.血清淀粉样物质A研究进展[J].现代检验医学杂志,2010,25(4):10-12.
Geng HL,Zhong RQ.Advances in research on serum amyloid A[J].J Mod Lab Med,2010,25(4):10-12.
[5] Eras Z,Oguz S,Dizdar EA,et al.Serum amyloid-A levels in neonatal necrotizing enterocolitis[J].J Clin Lab Anal,2011,25(4):233-237.
[6] Hawkins JS,Wu Q,Wang Y,et al.Deficits in serum amyloid A contribute to increased neonatal mortality during murine listeriosis[J].Pediatr Res,2013,74(6):668-674.
[7] 罗 强,邓勤勤,易四维,等.利用降钙素原判断细菌感染的临床符合性分析[J].热带医学杂志,2014,14(1):84-87.
Luo Q,Deng QQ,Yi SW,et al.Evaluation of using procalcitonin in the diagnosis of bacterial infection[J].J Tropi Med,2014,14(1):84-87.
[8] Wang HE,Shapiro NI,Safford MM,et al.High-sensitivity C-reactive protein and risk of sepsis[J].PLoS One,2013,8(7):e69232.

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备注/Memo

备注/Memo:
作者简介:罗 强(1978-),男,硕士,副主任技师,专业:临床微生特,E-mail:luoqiang4313@163.com。
更新日期/Last Update: 2015-08-10