儿童肺炎支原体肺炎的血清降钙素原和C-反应蛋白的改变

Serum PCT and CRP measured in children patients with mycoplasmal pneumonia (MPP)

目的探讨肺炎支原体肺炎(MPP)患儿的血清降钙素原(PCT)含量和C-反应蛋白改变及临床意义。方法2005年6月至2005年10月诊断为MPP的住院患儿56例,其中急性期病人33例,恢复期病人23例,正常体检儿童13例作为对照组。住院24小时内取静脉血2ml,离心后取血清定量测定PCT,对各组PCT、CRP进行比较。结果急性期和恢复期血清PCT值分别为0.27(0.17～0.35)ng/ml、0.18(0.13～0.23)ng/ml,正常对照组为0.14(0.13～0.16)ng/ml。急性期PCT观测值与恢复期比较差异有显著性(P<0.05),恢复期PCT与正常对照差异无显著性(P>0.05)。急性期和恢复期血清CRP值分别为16.2(8～25.5)mg/L、8(8～8)mg/L,急性期高于恢复期(P<0.01)。结论肺炎支原体肺炎患儿在急性期PCT、CRP仅轻度增高,恢复期降至正常范围。PCT测定有利于鉴别诊断细菌性肺炎和非细菌性肺炎;但不能区分病毒和支原体感染,需要进一步结合病原学检查(如呼吸道病毒检测、支原体抗体等)及临床特点明确诊断。

Objective To measure PCT and CRP in children patients with MPP and value its clinical significance . Methods The 56 cases in MPP group were diagnosed and selected from patients in hospital from June to October 2005, including 33 cases in acute stage and 23 cases in recovery stage. The specimen was drawn from peripheral vein within 24h after admission, meanwhile the specimen was drawn from 13 children in normal as control. Fluorescent immunoassay was employed to measure PCT. Results PCT levels of acute stage and recovery stage were 0.27 （0.17- 0.35） ng/ml,0. 18 （0. 13 - 0.23 ） ng/ml , respectively; it was 0. 14 （ 0. 13 - 0. 16 ） ng/ml in control group. There were significant differences in PCT between acute stage group and recovery stage group （ P 〈 0.05 ）, and no differences between recovery stage group and the normal control group （ P 〉 0.05 ）. CRP levels of acute stage and recovery stage were 16.2（ 8 - 25.5 ） mg/L,8 （ 8 - 8 ） mg/L, respectively. There were significant differences in CRP between acute stage group and recovery stage group （P 〈0.01 ）, and there were no differences between recovery stage group and the normal control group, respectively. （P 〉 0.05）. Conclusion PCT ,CRP evaluated mildly in MPP during actue stage , then returned to normal level in recovery stage. PCT detection was beneficial to differential diagnosis between bacterial pneumonia and non-bacterial pneumonia. However, PCT detection could not distinguish viral infection from mycoplasmal infection. In addition to clinical features, aetiology study, ineluding viral examination and mycoplasma antibody detection, should be employed in differential diagnosis of MPP.