CAJ | 학술논문

目的：探讨人中性粒细胞载脂蛋白（HNL）在老年急性呼吸道感染患者细菌和病毒感染鉴别诊断中的临床价值。方法将142例老年呼吸道感染患者根据感染情况分为细菌组（96例）、病毒组（46例），将同期42例健康体检者作为对照组。分别采用酶联免疫吸附测定法及高敏感干化学微粒增强型免疫浊度法检测其血HNL及C反应蛋白（CRP），同时进行病毒特异性抗体检测。结果细菌组患者血HNL、CRP水平及其检测阳性率分别与病毒组、对照组比较，差异有统计学意义（P＜0．01）；而病毒组与对照组上述指标的差异无统计学意义（P＞0．05）。抗菌药治疗前及治疗后24、48、72h检测，HNL浓度分别为（216．8±64．1）、（192．0±41．2）、（158．0±54．5）及（87．0±12．4）μg/L，CRP浓度分别为（50．9±40．9）、（46．2±18．3）、（39．6±9．6）及（12．6±9．8）mg/L。HNL检测的敏感性、特异性、阳性预测值及阴性预测值分别为90．6％、90．9％，91．5％、89．9％，均高于CRP的相关指标（分别为88．5％、85．2％、86．7％及87．2％），差异有统计学意义（P＜0．05）。结论NHL检测对老年急性呼吸道感染患者细菌和病毒感染的鉴别诊断具有重要意义。
목적：탐토인중성립세포재지단백（HNL）재노년급성호흡도감염환자세균화병독감염감별진단중적림상개치。방법장142례노년호흡도감염환자근거감염정황분위세균조（96례）、병독조（46례），장동기42례건강체검자작위대조조。분별채용매련면역흡부측정법급고민감간화학미립증강형면역탁도법검측기혈HNL급C반응단백（CRP），동시진행병독특이성항체검측。결과세균조환자혈HNL、CRP수평급기검측양성솔분별여병독조、대조조비교，차이유통계학의의（P＜0．01）；이병독조여대조조상술지표적차이무통계학의의（P＞0．05）。항균약치료전급치료후24、48、72h검측，HNL농도분별위（216．8±64．1）、（192．0±41．2）、（158．0±54．5）급（87．0±12．4）μg/L，CRP농도분별위（50．9±40．9）、（46．2±18．3）、（39．6±9．6）급（12．6±9．8）mg/L。HNL검측적민감성、특이성、양성예측치급음성예측치분별위90．6％、90．9％，91．5％、89．9％，균고우CRP적상관지표（분별위88．5％、85．2％、86．7％급87．2％），차이유통계학의의（P＜0．05）。결론NHL검측대노년급성호흡도감염환자세균화병독감염적감별진단구유중요의의。
Objective Toinvestigatetheclinicalvalueofhumanneutrophillipocalin(HNL)detectioninthedifferentialdiagnosis of bacterial and viral infections of elderly patients with acute respiratory infection .Methods 142 elderly patients with respiratory infection were divided the bacteria group (96 cases) and the virus group (46 cases) according to their infections ,42 healthy people in the corresponding period were enrolled as the control group .Enzyme-linked immunosorbent assay and highly sensitive dry chemi-cal particles enhanced immune turbidity assay were employed to detect their blood HNL and C-reactive protein(CRP) ,respectively , and virus-specific antibodies detection were performed simultaneously .Results Compared the blood HNL ,CRP levels and their positive rates of patients in bacteria group with those in the virus group ,control group ,respectively ,differences showed statistically significant(P<0 .01) ,while the differences of indicators listed above between the virus group and control group had no statistically significant(P>0 .05) .Antibiotic treatment before and 24 ,48 and 72 hours after ,the concentrations of HNL were (216 .8 ± 64 .1) , (192 .0 ± 41 .2) ,(158 .0 ± 54 .5) and (87 .0 ± 12 .4)μg/L ,respectively ,while those of CRP were (50 .9 ± 40 .9) ,(46 .2 ± 18 .3) , (39 .6 ± 9 .6) and (12 .6 ± 9 .8) mg/L ,respectively .Sensitivity ,specificity ,positive predictive value and negative predictive value of HNL detection were 90 .6% ,90 .9% ,91 .5% and 89 .9% ,respectively ,which were higher than those of CRP (88 .5% ,85 .2% , 86 .7% and 87 .2% ,respectively) ,with statistically significant difference(P<0 .05) .Conclusion NHL detection possesses impor-tant significance in differential diagnosis between bacterial and viral infections of elderly patients with acute respiratory infection .