| ObjectiveAnalyze the changes of serum amyloid A(SAA),c-reactive protein(CRP)and procalcitonin(PCT)levels in children infected with mycoplasma pneumoniae(MP)and the changes of immune function(serum immunoglobulin and peripheral blood t-lympho-cyte subsets)after MP infection.And explore the relationship between changes in SAA and changes in immune function,to study the significance of SAA in the course of infection of children with Mycoplasma pneumoniae,to find a simple and effective method for MP diagnosis.Methods152 children with MP infection who were hospitalized in Taian Central Hospital of Shandong Province from December 2018 to March 2019 were selected as MP observation group,and 50 randomly selected healthy children were selected as control group to analyze SAA,CRP and PCT in the acute,recovery,and healthy controls of children with MP,as well as serum immunoglobulin and peripheral blood T lymphocyte subsets in both groups;and 30 of them were tested for one week in a row.The outcome of SAA and immune function in children,and whether the trend between the two has a relationship.Statistical analysis was performed on the obtained data using SPSS20.0.The count data usage rate(%)was used.The comparison between groups was performed byχ~2 test.The measurement data were expressed by mean±standard deviation(Mean±SD).t test,if the variance is not uniform,the approximate t test is used,and the difference is statistically significant at P<0.05.The F test was used for comparison between groups,and the q test was used for comparison between groups.Results1.The serum levels of SAA,CRP and PCT in the acute phase of MP infection were significantly higher than those in the control group(P<0.05),and the recovery period was significantly lower than that in the acute phase(P<0.05).2.Results of serum SAA,CRP,PCT on the diagnosis of MP infection by ROC curve:serum SAA cut-off value was 203.56 mg/L,sensitivity was 86.7%,specificity was 83.3%(AUC=0.924,P<0.05):When the serum CRP cut-off value was 32.6 mg/L,the sensitivity was 80.0%,the specificity was 80.0%(AUC=0.861,P<0.05);when the serum PCT cut-off value was 1.12 ng/mL,the sensitivity was 70.0%.The degree was 73.3%(AUC=0.779,P<0.05).AUC(SAA)=0.924,AUC(CRP)=0.861,AUC(PCT)=0.779,and P<0.05.It can be concluded that SAA is the most sensitive for diagnosing MP infection.3.In terms of immunoglobulin,IgA and IgM levels in the acute phase of the observation group were higher than those in the control group(P<0.05),and the recovery phase was decreased(P<0.05).There was no statistically significant difference in IgG(P>0.05).Results:the ratios of CD3~+T cells(%),CD4~+T cells(%)and CD4~+/CD8~+T cells in the children with acute MP infection were significantly lower than those in the healthy control group(P<0.05),and CD8~+T cells(%)in the infected group were significantly higher than those in the control group(P<0.05).There was a significant difference between the MP infection group in the acute phase and the recovery phase(P<0.05).4.There was a correlation between serum SAA and immune function changes,positive correlation with IgA,IgM and CD8~+T cells(%),and negative correlation with CD3~+T cells(%),CD4~+T cells(%)and CD4~+/CD8~+T cells.Conclusion1.Serum SAA,CRP and PCT levels were significantly increased in the acute phase of MP infection in children,and the detection of serum SAA,CRP and PCT(especially SAA)levels in MP infection children has great auxiliary value for the diagnosis of early MP infection.2.The immune function of the children infected with MP was significantly changed,with elevated IgA and IgM levels of humoral immunity,increased CD8~+T cells(%),decr-eased CD3~+T cells(%),CD4~+T cells(%)and CD4~+/CD8~+T cells in cellular immunity.3.The change of SAA can reflect the change trend of immune function in MP infected children,and the detection of SAA is convenient and fast,requiring only peripheral blood,which is easy to be accepted by children and their families.It is of great significance to evaluate the condition in time and guide clinical medication. |
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