| 王 星,刘 辉,庞 辉,董玉婷,祁海峰.血清SAA、YKL-40及SP-A的联合检测对小儿难治性肺炎支原体肺炎的预测价值分析[J].,2023,(7):1309-1314 |
| 血清SAA、YKL-40及SP-A的联合检测对小儿难治性肺炎支原体肺炎的预测价值分析 |
| Analysis on Predictive Value of Combined Detection of Serum SAA, YKL-40 and SP-A in Predicting Refractory Mycoplasma Pneumoniae Pneumonia of Children |
| 投稿时间：2022-08-23 修订日期：2022-09-18 |
| DOI：10.13241/j.cnki.pmb.2023.07.021 |
| 中文关键词: 血清淀粉样蛋白A 几丁质酶样蛋白YKL-40 肺表面活性物质相关蛋白-A 难治性肺炎支原体肺炎 预测价值 |
| 英文关键词: Serum amyloid protein A YKL-40 Surfactant associated protein-A Refractory mycoplasma pneumoniae pneumonia Predictive value |
| 基金项目:陕西省高校科协人才托举计划项目（20200310） |
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| 中文摘要: |
| 摘要 目的：探究血清淀粉样蛋白A（SAA）、几丁质酶样蛋白YKL-40和肺表面活性物质相关蛋白-A（SP-A）表达水平对的联合检测对小儿难治性肺炎支原体肺炎（RMPP）的预测价值。方法：纳入2019年11月至2021年12月期间我院收治的60例MPP患儿作为研究对象，依据病情最终转归将其分为RMPP组和普通肺炎支原体肺炎（GMPP）组，另纳入同期于我院行体格检查的60例健康儿童作为对照组。收集所有受试儿童的临床资料、实验室指标及影像学结果，采用酶联免疫吸附法（ELISA）检测血清SAA、YKL-40和SP-A的表达水平，应用受试者工作特征曲线（ROC）判定各指标单项检测和联合检测的预测效能。结果：MPP组患儿和对照组儿童一般资料相比无统计学差异（P＞0.05）。依据病情最终转归，60例MPP患儿中共有23例（38.33 %）进展为RMPP，RMPP组与GMPP组患儿在白介素-6（IL-6）、C-反应蛋白（CRP）、降钙素原（PCT）、D-二聚体（D-D）等实验室指标以及肺不张、胸腔积液等影像学特征方面相比有统计学差异（P＜0.05）。RMPP组和GMPP组血清SAA、YKL-40和SP-A的表达水平显著高于对照组（P＜0.05），同时RMPP组血清SAA、YKL-40和SP-A的表达水平显著高于GMPP组（P＜0.05）。血清SAA的最佳截断值为39.75 mg/L，预测RMPP发生的ROC曲线下面积为0.894（95%CI：0.861-0.925），敏感度为78.26 %，特异度为86.67 %；血清YKL-40的最佳截断值为31.85 ng/mL，预测RMPP发生的ROC曲线下面积为0.754（95%CI：0.634-0.873），敏感度为73.91 %，特异度为67.21 %；血清SP-A的最佳截断值为35.59 ng/mL，预测RMPP发生的ROC曲线下面积为0.761（95%CI：0.640-0.891），敏感度为73.91 %，特异度为75.00 %；SAA+YKL-40-1+SP-A三者联合检测预测RMPP的AUC为0.914（95%CI：0.871-0.957），敏感度为91.30 %，特异度为91.66 %。结论：血清SAA、YKL-40和SP-A表达水平的检测可作为预测RMPP发生的重要生物学指标，且三者联合检测的预测效能较高，可为临床尽早诊断RMPP、尽早干预、改善患儿预后提供一定的帮助。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the predictive value of combined detection of serum amyloid protein A(SAA), YKL-40 and surfactant associated protein-A(SP-A) in predicting refractory mycoplasma pneumoniae pneumonia(RMPP) of children. Methods: 60 MPP children admitted to our hospital from November 2019 to December 2021 were collected as research group, and were divided into RMPP group and general mycoplasma pneumoniae pneumonia(GMPP) group according to transition, another 60 healthy children were collected as control group. All clinical data, laboratory indexes and radiological results were collected, the serum SAA, YKL-40 and SP-A of all children were detected by ELISA, the predictive value each index was evaluated by receiver operating characteristic curve(ROC). Results: The general information of MPP and healthy children had no difference (P＞0.05). According to transition, 23(38.33%) of 60 MPP children were progressed to RMPP, the expression of interleukin-6(IL-6), C-reactive protein(CRP), procalcitonin(PCT), D-dimer(D-D), atelectasis and hydrothorax of RMPP group and GMPP group were significantly different(P＜0.05). The expression levels serum SAA, YKL-40 and SP-A of RMPP group and GMPP group were higher than control group(P<0.05), and the RMPP group was higher than GMPP group(P<0.05). ROC analysis showed that the optimal cut-off value, AUC, sensitivity and specificity of SAA were 39.75 mg/L, 0.894(95%CI: 0.861-0.925), 78.26 % and 86.67 %; the optimal cut-off value, AUC, sensitivity and specificity of YKL-40 were 31.85 ng/mL, 0.754(95%CI: 0.634-0.873), 73.91 % and 67.21 %; the optimal cut-off value, AUC, sensitivity and specificity of SP-A were 35.59 ng/mL, 0.761(95%CI: 0.640-0.891), 73.91 % and 75.00 %; the AUC, sensitivity and specificity of SAA+YKL-40-1+SP-A were 0.914(95%CI: 0.871-0.957), 91.30 % and 91.66%. Conclusion: The expression levels of SAA, YKL-40-1 and SP-A could be important biological indicators in predicting occurrence of RMPP, and combined detection of three indexes had higher predictive efficiency, while could provide certain help for early diagnosis, early intervention and improvement of prognosis of children. |
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