Diagnostic value of serum amyloid A combined with C-reactive protein detection in children with hand-foot-mouth disease / 中华传染病杂志

ABSTRACT

Objective To explore the clinical application value of serum amyloid A (SAA),C-reactive protein (CRP) and SAA/CRP in early diagnosis of hand-foot-mouth disease (HFMD).Methods The serum levels of SAA and CRP were detected in 873 children with HFMD who were admitted in Hangzhou Children's Hospital from April to December in 2015.And 487 healthy children were enrolled as healthy control group.SAA was measured by nephelometry assay,and CRP was measured by immunoturbidimetry.Variables were compared using Mann-Whitney U test and diagnostic value was measured by using receiver operating characteristic (ROC) curve.Results The median levels of SAA in HFMD group and control group were 330.5 and 4.0 mg/L,respectively,which was statistically different (Z=-29.02,P＜0.01);the median levels of CRP were 10.0 and 1.0 mg/L,respectively,with statistical difference (Z =23.79,P＜ 0.01);and the median SAA/CRP were 23.06 and 2.40,respectively,with statistical difference (Z=-24.79,P＜0.01).In ROC curve comparison,the area under the curve of SAA (0.980) was higher than those of SAA/CRP ratio (0.911) and CRP (0.899) for diagnosing HFMD.When using 10.30 mg/L as the cut off value for SAA according to the ROC curve,the sensitivity was 91.6％ and the specificity was 96.6％.Conclusions Joint detection of SAA and CRP can improve the efficiency in the early diagnosis of HFMD.SAA can provide useful auxiliary information for the diagnosis of HFMD,which is worthy of extensive clinical application.