| Objective: The objective of this experiment was to discuss the expression level of CXCL16 in the sera of children with bacterial infectious diarrhea(BID)and rotavirus infectious diarrhea(RID)and its correlation,and to investigate the role of CXCL16 in the pathogenesis of acute infectious diarrhea(AID)and its correlation with the severity of AID.To investigate the role of CXCL16 in the pathogenesis of children with acute infectious diarrhea(AID)and its correlation with the severity of AID,and to provide a potential method for early diagnosis and prediction of AID in children.Methods:From October 2020 to September 2022,60 children with AID who were hospitalized in the pediatric ward were selected as the experimental group.They were divided into BID group and RID group with 30 cases.According to the clinical symptoms,the BID group was divided into mild BID group(22 cases)and severe BID group(8 cases).Similarly,the RID group was classified into two categories with mild RID group(n=23)and severe RID group(n=7).As the control group,30 children were selected at the same period.They underwent health check-ups at our pediatric outpatient clinic.In the experimental group,3ml of venous blood was collected on the day of admission and 5 days after treatment.In the control group,they were collected on the day of visit.By enzyme-linked immunosorbent assay(ELISA),the serum CXCL16 levels of the above three groups were measured.Analyze the differences of CXCL16 among the three groups before and after treatment.The receiver operating characteristic(ROC)curve was used to analyze the CXCL16 level to evaluate its predictive value for AID and its efficacy in identifying the types of pathogens.At the same time,the gender and age of the above three groups of children and the body temperature,vomiting,abdominal pain,dehydration,stool characteristics,blood routine WBC,CRP,PCT and other laboratory data of the experimental group were recorded and statistically analyzed.Results:1.There was no significant difference in gender and age among the three groups.There was no statistical difference in the comparison of temperature,vomiting,abdominal pain,and dehydration among the children in the experimental group(P>0.05).2.The occurrence rate of bloody stools and pus stools were higher in the BID group(P<0.05).The incidence rate of dilute watery stools was higher in the RID group with statistically significant(P<0.05).The incidence rate of mucus stools and dilute pasty stools were not significantly different between the two groups.3.In the experimental group,the CRP level and PCT level were significantly higher,and those in the BID group were higher than the RID group,with statistical significance(P<0.05).In the BID group,the WBC level was significantly higher(P<0.05).There was no observable difference between the other two groups.4.CXCL16 was detected in the serum of children above three groups.The serum CXCL16 expression level was observably higher,and the BID group was higher with statistically significant(P < 0.05).5.Before treatment,the expression level of CXCL16 in the experimental group was obviously higher than that after treatment.The severe experimental group was higher than that in the light experimental group.The differences were statistically significant(P < 0.05).After treatment,there was no statistical difference between the severe experimental group and the mild experimental group.6.In the experimental group,the CXCL16 level was positively correlated with CRP level and PCT level(CRP: r=0.527;r=0.412,PCT: r=0.370;r=0.363,P < 0.05).There was no correlation between CXCL16 and CRP or PCT levels in the experimental group after treatment(P > 0.05).7.The ROC curve of CXCL16,CRP,PCT and CXCL16 combined with PCT in the diagnosis of AID showed that the area under the curve(AUC),sensitivity and specificity of CXCL16 were 0.84,78.33% and 83.33%,respectively,and the best cut-off value was 3.69ng/ml.The AUC,sensitivity and specificity of CRP were 0.71,71.67% and 63.33%,respectively,and the best cut-off value was 3.40mg/L.The AUC,sensitivity and specificity of PCT were 0.81,93.33% and 63.33%,respectively,and the best cut-off value was 0.91ng/ml.The AUC,sensitivity and specificity of CXCL16 combined with PCT in the diagnosis of AID were 0.89,93.33% and 73.33%,respectively.CXCL16,CRP and PCT have certain predictive value for the diagnosis of AID.The AUC and specificity of CXCL16 are higher than those of CRP and PCT.The AUC and sensitivity of CXCL16 combined with PCT are higher,and the diagnostic value of AID is better than CXCL16,CRP or PCT alone.8.The differential efficacy of CXCL16,CRP,PCT and CXCL16 combined with PCT for BID and RID were analyzed by ROC curve:the area under the curve(AUC),sensitivity and specificity of CXCL16 were 0.83,83.33% and 76.67%,respectively,and the best cut-off value was 4.64ng/ml.The AUC,sensitivity and specificity of CRP were 0.74,83.33% and 63.33%,respectively,and the best cut-off value was 6.33mg/L.The AUC,sensitivity and specificity of PCT were 0.78,66.67% and 73.33%,respectively,and the best cut-off value was 1.05ng/ml.The AUC,sensitivity and specificity of CXCL16 combined with PCT were 0.87,83.33% and 80.00%.CXCL16 has a high AUC,sensitivity and specificity for differentiating BID from RID.CXCL16 combined with PCT has the highest AUC,sensitivity and specificity for differentiating BID from RID,which is better than CXCL16,CRP or PCT alone.Conclusions:1.The expression of CXCL16 is elevated with AID,and the level of CXCL16 is positively correlated with the severity of AID in children.2.The predictive value of CXCL16 for BID is better than that of CRP and PCT,and the diagnostic value of CXCL16 combined with PCT is better than that of single diagnosis,which can be used as a predictor of BID.3.CXCL16 has a good advantage in identifying the pathogenic types of AID in children,and CXCL16 combined with PCT has a higher identification efficiency. |
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