Differential diagnosis of respiratory tract infection types in children by combining peripheral blood cell morphological changes with SAA and PCT
Objective To study the value of combining peripheral blood cell morphological changes with serum amy-loid A(SAA)and procalcitonin(PCT)in differential diagnosis of respiratory infection types in children with normal blood routine,and to provide reference for clinical rapid diagnosis.Methods A total of 276 children with respiratory tract infection with normal blood routine were selected from Handan First Hospital from August 2021 to July 2023 as the research subjects,including 51 cases of bacterial infection(bacterial group),98 cases of Mycoplasma pneumo-niae infection(mycoplasma group)and 127 cases of viral infection(viral group),and 50 healthy children were se-lected as the control group during the same period.Compare the morphological changes of peripheral blood cells,SAA and PCT levels in each group,and analyze the differential diagnostic value of peripheral blood cell morphologi-cal changes,SA A and PCT single and combined detection for pediatric respiratory tract infection types through re-ceiver operating characteristic(ROC)analysis.Results The number of left nuclear shift,grade of neutrophil toxic par-ticles,proportion of reactive lymphocytes,levels of SAA and PCT in children with respiratory tract infection were higher than those in the control group(P＜0.05).The number of left nuclear shift,grade of neutrophil toxic particles,levels of SAA and PCT in the bacterial and mycoplasma groups were higher than those in the viral group,the pro-portion of reactive lymphocytes was lower than that of viral group(P＜0.05),the number of left nuclear shift,grade of neutrophil toxic particles,levels of SAA and PCT in the bacterial group were higher than those in the mycoplasma group,the proportion of reactive lymphocytes was lower than that in the mycoplasma group(P＜0.05).The ROC curve showed that the AUC for differential diagnosis of bacterial infection,mycoplasma infection and viral infection by left nuclear shift+neutrophil toxic particles classification+reactive lymphocyte proportion+SAA+PCT was 0.885,0.922 and 0.901,respectively,which was higher than the AUC when each test item was applied separately.Conclusion Peripheral blood cell morphology,SAA and PCT showed different characteristics of changes in the etiology of differ-ent respiratory tract infections in children with normal blood routine.In the case that traditional detection methods could not reflect clinical manifestations,the three mothods were expected to provide strong evidence for infection and etiological identification value for clinical diagnosis and treatment.It was helpful to improve the efficiency and accu-racy of diagnosis and treatment of respiratory tract infection in children.
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