Serum Amyloid A And Calcitonin Original Four Indexes Such As Children With Community-acquired Pneumonia Correlation Studies

BackgroundCommunity acquired pneumonia(CAP)refers to infectious inflammation of lung parenchyma(including alveolar wall)outside the hospital(community),including pneumonia with a definite incubation period outside the hospital(community)and within the average incubation period after admission.CAP is one of the most common diseases in our country,which is the main cause of child death,and can occur at all stages of children,especially children under 5 years of age.Early diagnosis and treatment is very important to improve prognosis.At present,laboratory testing methods for children CAP mainly include pathogenic microbiology and serological detection.The "gold standard" of CAP differential diagnosis in pathogenic microbiological detection,but conventional microbial culture takes a long time,the test results are easily affected by environment,specimen collection and other factors,and negative can not rule out infection.In recent years,with the application of mass spectrometer in microbial identification,although bacteria and some fungi can be identified quickly,mass spectrometry is still based on culture and can not achieve early diagnosis.PCR detection or antigen-antibody detection speed,but only limited to part of the pathogen detection.Pathogen detection is unknown,which affects the implementation of timely and personalized treatment programs for clinicians.In general,serum inflammatory markers are widely used in the process of diagnosis and treatment of CAP in children.However,there is no reliable single test to identify the specific pathogen causing pneumonia.Therefore,in clinical aspects,we should popularize a variety of combined detection of serum inflammatory markers as much as possible,andexplore an effective diagnostic model.In this way,the accuracy and sensitivity of the determination will be greatly increased.the diagnostic value of procalcitonin(PCT)in bacterial infection and the value of serum amyloid A(SAA)in viral infection have been recognized by many experts;hypersensitive C reactive protein hs-CRP)and interleukin6(IL-6)are widely used in infectious diseases.For this purpose,this study collected the results of these four serum inflammatory markers in children CAP patients.Using statistical method,the effectiveness of multi-indicator combined detection in determining whether there is infection was investigated.At the same time,the test indexes are optimized to explore new mathematical diagnostic patterns and to judge their feasibility in the process of CAP differential diagnosis.ObjectiveTo investigate the clinical value of serum amyloid A(SAA),hypersensitive C reactive protein(hs-CRP),procalcitonin(PCT)and interleukin 6(IL-6)in the differential diagnosis of children with community-acquired pneumonia.Based on these four serum inflammatory markers,we explored the diagnostic model CAP differential diagnosis and relative boundary value(cut-off).MethodsThe serum SAA,hs-CRP,PCT,IL-6 data of 70 children with bacterial CAP,40 children with viral CAP,40 children with pneumonia branch CAP and 50 normal children were detected.The differences between the groups were analyzed.The value of SAA,hs-CRP,PCT,IL-6 single and combined with a variety of serum inflammatory markers in detecting CAP was studied by ROC(Receiver Operating Characteristic)curve of the subjects,and the corresponding Cut-off values were calculated.Results1 The SAA、hs-CRP、PCT、IL-6 content in serum of children CAP patients was higher in the bacterial group than in the healthy control group(P<0.05),which was statistically significant.2 The SAA、hs-CRP content in serum of children CAP patients was higher in the viral group than in the healthy control group(P<0.05),which was statistically significant.3 The serum SAA、hs-CRP、IL-6 content in children CAP patients was higher in mycoplasma pneumoniae group than in healthy control group(P<0.05).4 The AUC of SAA、hs-CRP、PCT、IL-6 and four indexes in diagnosing bacterial CAP were 0.795,0.764,0.962,0.778,0.642.The sensitivity of each in the diagnosis of bacterial CAP were 56.52%,57.97%,89.86%,53.62%,and specificity were 90.08%,87.02%,96.95%,93.86%.5 SAA,hs-CRP and PCT,IL-6 and joint detection in the diagnosis of viral CAP of four index,AUC were 0.546,0.504,0.363,0.284,0.500;Diagnostic model detection of SAA/hs-CRP,SAA/PCT,SAA/IL-6 when the ratio of the diagnosis of viral CAP,AUC were0.425,0.825,0.700;Sensitivity 65.00%,82.50%,95.00%.77.50%,and specificity were95.51%,75.00%;The Cut-off value is 8.09,102.5,13.78 respectively.6 SAA,hs-CRP,PCT,IL-6 and 4 indexes combined detection in the diagnosis of Mycoplasma pneumoniae pneumonia,AUC were 0.537,0.500,0.309,0.595,0.563;Diagnostic model detection of IL-6 / hs-CRP,IL-6 / SAA,IL-6 / PCT when the ratio of the diagnosis of Mycoplasma pneumoniae pneumonia,AUC were 0.709,0.531,0.892;Sensitivity were 62.50%,31.25% 、 75.00% and specificity were77.50%,68.75% 、96.25%.The Cut-off value is 0.88,0.36,51 respectively.Conclusion1 The ratio of SAA to PCT used in detection has high diagnostic value for viral CAP.2 The ratio of IL-6 to PCT used in detection has high diagnostic value for mycoplasma pneumoniae CAP.