Prognostic Value of Serum SAA and hs-CRP in Children with Severe Pneumonia

DU Xingyue; QI Xusheng; XU Liqin; HE Yi; GUO Xin; WANG Ruolan; ZHOU Yalan

doi:10.3639/j.issn.2095-3097.2025.04.007

Abstract：Objective To explore the prognostic value of serum amyloid A(SAA)and high-sensitivity C-reactive protein(hs-CRP)in children with severe pneumonia.Methods A total of 110 children with pneumonia admitted to Tai-he Hospital were enrolled as the research objects between January 2021 and October 2024.According to disease severity,they were divided into the severe group(n=64)and the mild group(n=46).The levels of serum SAA and hs-CRP in two groups were compared,and the correlation between the above indexes and the severity of pneumonia was analyzed by Spearman correlation analysis.According to disease outcomes,children in the severe group were divided into the good prognosis group(n=38)and the poor prognosis group(n=26),serum SAA,hs-CRP and other basic data in the two groups were compared.The risk fac-tors of poor prognosis were analyzed by multivariate logistic regression analysis.The prognostic value of serum SAA and hs-CRP was analyzed by receiver operating characteristic(ROC)curves.Results The levels of SAA and hs-CRP in the severe group were(36.80±6.17)mg/L and(15.71±2.01)mg/L,higher than those in the mild group[(26.65±5.16)mg/L,(11.91±1.43)mg/L],the differences among two groups were statistically significant(P＜0.05).The results of Spearman analysis showed that the levels of serum SAA and hs-CRP were positively correlated with the severity of pneumonia(r=0.883,0.914,both P＜0.05).The levels of serum SAA and hs-CRP in the good prognosis group were lower than those in the poor prognosis group(P＜0.05).The results of ROC curve analysis showed that the area under the curve(AUC),sensitivity and specificity of serum SAA combined with hs-CRP were 0.890(95％CI:0.786-0.954),97.37％and 80.77％,which were significantly better than those of a single index(SAA AUC=0.660,hs-CRP AUC=0.732).Multivariate logistic regression analysis showed that SAA 37.14 mg/L(OR=1.826,95％CI:1.154-2.888)and hs-CRP≥ 15.53 mg/L(OR=1.775,95％CI:1.014-3.110)were independent risk factors of poor prognosis in children with severe pneumonia(P＜0.05).Conclusion The levels of serum SAA and hs-CRP are abnormal in children with severe pneumonia.The two indexes are closely related to disease severity and are influencing factors of prognosis.Combined detection of SAA and hs-CRP has high prognostic value,and they can be applied as effective biological indexes to clinically evaluate disease severity and predict outcomes.