刘敏方 钟绍杰 鄢华勤 孙君璐

【摘要】 目的：探讨血清淀粉样蛋白A（SAA）检测与肺炎支原体肺炎（MPP）的病情轻重的相关性，及其在重症MPP诊断中的临床价值。方法：选取2019年5-12月于本院儿科就诊的65例MPP患儿为研究对象。根据患儿病情分为重症组40例及轻症组25例，再选取25例同期健康体检儿童作为对照组。观察研究对象的体温变化、气促情况、住院时长等。结果：住院时长≥7 d、入院体温≥38.5 ℃患儿SAA浓度均显著高于住院时长<7 d、入院体温<38.5 ℃患儿，差异均有统计学意义（P<0.05）。发热时长≥3 d患儿PCT浓度显著高于发热时长<3 d患儿，差异有统计学意义（P<0.05）。轻症组、重症组SAA、CRP、WBC、PCT水平均高于对照组（P<0.05），重症组SAA水平高于轻症组（P<0.05）;但轻症组、重症组WBC、CRP及PCT水平比较，差异均无统计学意义（P>0.05）。MPP患儿的入院体温与SAA浓度存在正相关（P<0.05）。结论：SAA与MPP临床症状的轻重程度存在一定的相关性，能较好地反映病情进展，在重症MPP的诊断中也优于其他炎性指标，具有较高的临床应用价值。

【关键词】 血清淀粉样蛋白A 肺炎支原体肺炎

[Abstract] Objective： To investigate the correlation between serum amyloid A （SAA） and the severity of mycoplasma pneumoniae pneumonia （MPP）， and its clinical value in the diagnosis of severe MPP. Method： 65 cases of MPP in our hospital from May to December 2019 were selected as the research objects. According to their condition， they were divided into severe group （40 cases） and mild group （25 cases）， and then 25 healthy children were selected as control group. The changes of body temperature， shortness of breath and length of hospital stay were observed. Result： The concentration of SAA in children with length of stay ≥7 days and body temperature ≥38.5 ℃ were significantly higher than those in children with length of stay <7 days and body temperature <38.5 ℃ （P<0.05）. The PCT concentration of children with fever duration ≥3 days was significantly higher than that of children with fever duration <3 days （P<0.05）. SAA， CRP， WBC and PCT levels in mild group and severe group were higher than those in control group （P<0.05）; SAA level in the severe group was higher than that in mild group （P<0.05）; but there were no significant differences in WBC， CRP and PCT levels between mild group and severe groups （P>0.05）. There was a positive correlation between admission temperature and SAA concentration in MPP children （P<0.05）. Conclusion： SAA has a certain correlation with the severity of clinical symptoms of MPP， which can better reflect the progress of the disease， and is superior to other inflammatory indicators in the diagnosis of severe MPP.

[Key words] Serum amyloid A Mycoplasma pneumoniae pneumonia

First-authors address： Dongguan Changan Hospital， Dongguan 523800， China

doi：10.3969/j.issn.1674-4985.2021.03.020

肺炎支原體（mycoplasma pneumoniae， MP）是导致肺炎支原体肺炎（mycoplasma pneumoniae pneumonia， MPP）的病原体，广泛流行于社区，经飞沫和直接接触传播，轻症MPP经常表现出一定的自限性，但仍有一部分病例进展成为重症肺炎，甚至可能会累及多个系统，危及生命，因而重症MPP成为儿科医师广泛关注的临床问题[1-2]。血清淀粉样蛋白A（serum amyloid A， SAA）是一种急性期时相反应蛋白，敏感性极高，可以反映机体感染及炎症控制的情况[3]。SAA检测用于细菌、病毒、支原体感染的鉴别诊断已陆续被报道。本研究以东莞市长安医院儿科就诊的65例MPP患儿为研究对象，拟探讨SAA水平是否与病情轻重存在相关性，并通过将SAA与PCT、WBC、CRP等指标进行比较，了解其在重症MPP中诊断价值，为临床治疗MPP提供参考依据。现报道如下。

1 资料与方法

1.1 一般资料 选取2019年5-12月于本院儿科就诊的65例确诊为MPP的患儿为研究对象，年龄

6个月～12岁，平均（4.03±2.49）岁;男36例，女29例;住院时长3～15 d，平均（6.66±1.71）d;其中重症肺炎40例，占61.5%，非重症肺炎25例，占38.5%，3例患儿出现胸腔积液。……