病毒性与细菌性感染腹泻患儿外周血CD64指数 SAA STREM-1 CRP水平及临床意义

doi:10.3969/j.issn.1006-6233.2025.04.022

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摘要 目的: 探究病毒性与细菌性感染腹泻患儿外周血CD64指数和血清淀粉样蛋白A(SAA)、可溶性髓系细胞触发受体-1(STREM-1)、C反应蛋白(CRP)水平及临床意义。方法: 纳入2022年9月至2024年9月收治的110例感染性腹泻患儿作为腹泻组,分析其粪便病原体感染特征,依据病原体感染类型,分为病毒组(病毒感染性腹泻,n=68)与细菌组(细菌感染性腹泻,n=42),对比两组患儿基线资料与临床指标,外周血CD64指数和血清SAA、STREM-1、CRP水平,采用ROC曲线分析外周血CD64指数、SAA、STREM-1、CRP水平对感染性腹泻患儿病原感染类型的鉴别诊断价值。结果: 110例感染性腹泻患儿中,病毒性感染患儿68例(61.82%),细菌性感染患儿42例(38.18%);病毒组水样便、WBC、IL-6、PCT水平低于细菌组(P<0.05),而脏器损伤情况高于细菌组(P<0.05);细菌组CD6指数、SAA、STREM-1、CRP均高于病毒组(P<0.05);以患儿不同病原体类型为状态变量,以CD6指数、SAA、STREM-1、CRP为检验变量,ROC曲线结果显示,CD6指数、SAA、STREM-1、CRP预测患儿为细菌感染性腹泻的AUC分别为0.983、0.887、0.982、0.954,95%CI分别为(0.958~1.000、0.825~0.949、0.961~1.000、0.904~1.000)。结论: 外周血CD64指数和血清SAA、STREM-1、CRP水平可有效鉴别细菌性腹泻与病毒性腹泻,对不同病原感染性腹泻早期鉴别诊断具有参考价值。

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	梁银
	景芳丽
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关键词 ：感染性腹泻, 淀粉样蛋白A, 可溶性髓系细胞触发受体-1, C反应蛋白, 儿童

Abstract：Objective: To explore the peripheral blood CD64 index and serum amyloid A (SAA),soluble triggering receptor expressed on myeloid cells-1 (STREM-1) and C-reactive protein (CRP) levels and differential diagnostic value in children with infectious diarrhea caused by viral and bacterial infections. Methods: A total of 110 children with infectious diarrhea admitted from September 2022 to September 2024 were included in diarrhea group,and their fecal pathogen infection characteristics were analyzed.According to the types of pathogen infection,they were divided into viral group (viral infectious diarrhea,n=68) and bacterial group (bacterial infectious diarrhea,n=42).The baseline data and clinical indicators,peripheral blood CD64 index and serum SAA,STREM-1 and CRP were compared among the two groups of children.ROC curve was drawn to analyze the diagnostic and differential value of peripheral blood CD64 index,SAA,STREM-1 and CRP levels on the pathogenic infection types in children with infectious diarrhea. Results: Among the 110 children with infectious diarrhea,there were 68 cases (61.82%) of viral infection and 42 cases (38.18%) of bacterial infection.The proportion of watery stool and levels of WBC,IL-6,and PCT in viral group were significantly lower than those in bacterial group (P<0.05) while the proportion of organ injury was significantly higher than that in bacterial group (P<0.05).The CD6 index,SAA,STREM-1,and CRP in bacterial group were significantly higher than those in viral group (P<0.05).Using different pathogen types in children as state variables and CD6 index,SAA,STREM-1 and CRP as test variables,ROC curve results showed that the AUCs of CD6 index,SAA,STREM-1 and CRP in predicting bacterial diarrhea in children were 0.983,0.887,0.982 and 0.954 respectively,95%CI were(0.958~1.000,0.825~0.949,0.961~1.000 and 0.904~1.000). Conclusion: Peripheral blood CD64 index and serum SAA,STREM-1 and CRP levels can effectively distinguish bacterial diarrhea from viral diarrhea,and have reference value for the early differential diagnosis of infectious diarrhea caused by different pathogens.

Key words： Infectious diarrhea Amyloid A Soluble triggering receptor expressed on myeloid cells-1 C-Reactive protein Children

基金资助:陕西省重点研发计划项目,(编号:S2017-ZDYF-YBXM-0293)

通讯作者: 景芳丽

引用本文:

梁银, 景芳丽, 田恬, 赵红. 病毒性与细菌性感染腹泻患儿外周血CD64指数 SAA STREM-1 CRP水平及临床意义[J]. 河北医学, 2025, 31(4): 662-667.
LIANG Yin, JING Fangli, TIAN Tian, et al. Exploring the Levels and Clinical Significance of CD64 Index SAA STREM-1 and CRP in Peripheral Blood of Children with Viral and Bacterial Diarrhea Infections. HeBei Med, 2025, 31(4): 662-667.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.04.022 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I4/662

[1] 吕秋艳,曲梅,刘海涛,等.北京市门头沟区感染性腹泻细菌病原谱构成及耐药性分析[J].医学动物防制,2022,38(1):53-55,59.
[2] 单鸣凤,崔荣星,周凯,等.92例儿童沙门菌肠炎病原学及临床特征[J].中华医院感染学杂志,2022,32(14):2212-2217.
[3] Dubar M,Frippiat JP,Remen T,et al.Comparison of sTREM-1 and associated periodontal and bacterial factors before/after periodontal therapy,and impact of psychosocial factors[J].Clin Periodontol,2020,47(9):1064-1078.
[4] 路钰夏,杨辉,王向辉,等.病毒感染性腹泻对儿童人群肠道菌群及IL-6、TNF-α、hs-CRP、IFN-γ水平的影响[J].中国实验诊断学,2022,26(6):842-846.
[5] 儿童急性感染性腹泻病诊疗规范(年版)编写审定专家组.儿童急性感染性腹泻病诊疗规范(2020年版)[J].中国医药科学,2020,10(21):249-256.
[6] Siciliano V,Nista EC,Rosa T,et al.Clinical management of infectious diarrhea[J].Rev Recent Clin Trials,2020,15(4):298-308.
[7] Gonzalez-Lopez E,Odriozola Herran A,Renuncio Garcia M,et al.CD64 expression on neutrophils as a potential biomarker for bacterial infection in ascitic fluid of cirrhotic patients[J].Infect Dis (Lond),2023,55(9):646-652.
[8] Bourgoin P,Soliveres T,Barbaresi A,et al.CD169 and CD64 could help differentiate bacterial from CoVID-19 or other viral infections in the Emergency Department[J].Cytometry A,2021,99(5):435-445.
[9] 林华兰,林美玫,吴明,等.儿童感染性腹泻病原菌类型及血清SAA、CRP水平对感染的鉴别价值分析[J].中国病原生物学杂志,2023,18(8):961-964,969.
[10] Lv YJ,Hu QL,Huang R,et al.The diagnostic and therapeutic value of the detection of serum amyloid A and C-reactive protein in infants with rotavirus diarrhea[J].Int Gen Med,2021,14(1):3611-3617.
[11] Rim S,Vedoy OB,Brenstad I,et al.Inflammation,the kynurenines,and mucosal injury during human experimental enterotoxigenic Escherichia coli infection[J].Med Microbiol Immunol,2024,213(1):2-14.
[12] 杨雪利,白静,宋紫霞,等.血清降钙素原联合可溶性髓样细胞触发受体-1对儿童细菌性腹泻和病毒性腹泻的鉴别诊断价值[J].中国当代儿科杂志,2020,22(8):887-891.
[13] Yang XL,Bai J,Song ZX,et al.Value of serum procalcitonin combined with soluble triggering receptor expressed on myeloid cells-1 in the differential diagnosis of bacterial and viral diarrhea in children[J].Chin Neonatol,2020,22(8):887-891.