摘要： 目的 建立健康儿童血清淀粉样蛋白A（SAA）的参考区间。方法 选取2020年1月至2021年9月河北北方学院附属第一医院1 200例0~12岁健康体检儿童作为健康组，另选取同期细菌感染患儿200例作为细菌组、病毒感染患儿150例作为病毒组、支原体感染患儿180例作为支原体组，检测各组SAA水平，建立健康儿童SAA参考区间并验证。结果 各组儿童SAA含量均呈正态分布（Z分别为0.021、0.055、0.042、0.055，均P > 0.05）。健康组SAA为（5.99±1.52） mg/L，不同年龄和性别的SAA比较差异均无统计学意义（均P > 0.05）。建立95%单侧上限，SAA参考区间为0~8.49 mg/L。本研究建立的SAA参考区间与专家共识SAA参考区间（0~10 mg/L）比较一致性较差（kappa=0.088，P < 0.001）。与依据专家共识的参考区间比较，依据本研究建立的参考区间筛查获得的细菌组、病毒组、支原体组的感染阳性率均明显增高（均P < 0.05）。结论 初步建立了健康儿童SAA参考区间，为（0~8.49） mg/L。依据此参考区间筛查细菌、病毒、支原体感染阳性率增高，有效降低了漏诊率。

健康儿童血清淀粉样蛋白A参考区间的建立

左路广¹, 陈雪², 尹晓颖³, 张立青⁴, 李文斌⁵, 李树铁⁶

1. 河北北方学院附属第一医院检验科, 河北 张家口 075000;
2. 河北北方学院附属第一医院产科, 河北 张家口 075000;
3. 河北北方学院附属第一医院重症监护室, 河北 张家口 075000;
4. 河北北方学院附属第一医院妇科, 河北 张家口 075000;
5. 河北北方学院附属第一医院儿内科, 河北 张家口 075000;
6. 河北北方学院附属第一医院老年医学科, 河北 张家口 075000

收稿日期:2021-10-21出版日期:2022-09-30发布日期:2022-09-03
通讯作者:左路广E-mail:zuoluguang@163.com
作者简介:左路广（1987-），男，主管检验师，本科.
基金资助:河北省医学科学研究课题计划（20211499）


关键词: 血清淀粉样蛋白A, 儿童, 参考区间
Abstract: Objective To establish the reference interval of serum amyloid A(SAA) in healthy children. Methods From January 2020 to September 2021, a total of 1 200 healthy children aged 0 to 12 years were selected from the First Affiliated Hospital of Hebei North University(healthy group). During the same period, 200 children with bacterial infections(bacterial group), 150 children with viral infections(virus group), and 180 children with mycoplasmal infections(mycoplasma group) were also recruited. The SAA level in each group was measured, and used to establish and validate the SAA reference interval for healthy children. Results The SAA level in each group showed a normal distribution(Z=0.021, 0.055, 0.042, 0.055, respectively, all P > 0.05). The mean SAA level in healthy children was 5.99±1.52 mg/L. There was no significant difference in the SAA levels among healthy children of different ages and sex(all P > 0.05). The reference interval of SAA was 0-8.49 mg/L, and the consistency between this new reference interval and the expert consensual reference interval of SAA(0-10 mg/L) was poor(kappa=0.088,P < 0.001). Compared with the reference interval proposed by experts, the infection positivity rates in the bacterial group, virus group, and mycoplasma group with respect to the reference screening interval established in this study were significantly higher(P < 0.05). Conclusion The established SAA reference interval in healthy children was 0-8.49 mg/L. With this interval, the positivity rates during the screening of bacterial, viral and mycoplasmal infections in children are higher, and this significantly reduces the rate of missed diagnoses.
Key words: serum amyloid A, children, reference interval
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