C-反应蛋白在儿童急性呼吸道感染的应用探讨

Clinical Application of CRP for the Pediatric Patients suffering from Acute Respiratory Infection

目的探讨C-反应蛋白(CRP)对急性呼吸道感染患儿的临床应用。方法267例患儿入院时和抗生素治疗72 h后分别静脉采血,检测血清CRP、肺炎支原体特异性抗体IgG和IgM及白细胞计数(WBC)。结果设CRP>5.0mg/L为阳性、WBC>11.0×109/L为阳性,细菌感染组CRP阳性率84%,WBC阳性率42%,χ2检验有显著差异(P<0.05)。细菌感染组和支原体感染组CRP和WBC明显增高,与正常对照组比较,t检验均有显著差异(P<0.05);病毒感染组无显著差异(P>0.05)。61例CRP>5.0mg/L患儿抗生素治疗后CRP下降明显,治疗前后CRP和WBC水平t检验,CRP有显著差异(P<0.05);WBC无显著差异(P>0.05)。结论CRP是鉴别细菌\支原体与病毒感染的敏感但非特异性的指标;可指导合理使用抗生素并判断疗效。

Objective To investigate the clinical application of CRP for the pediatric patients suffering from acute respiratory infection.Methods To collect the vein blood from 267 pediatric inpatients on admission and after 72 hours treatment by using antibiotic, examine the level of serum CRP, pneumonia mycoplasma IgG, IgM and white blood cell （WBC） counts.Results Using the CRP〉5.0mg/L and WBC〉 11.0 × 10^9/L as the positive justice standard. The positive ratio of CRP is 84% and that of WBC is 42% in bacteria infection group, χ^2-examinations show the significant difference （P〈0.05）. The level of CRP and the counts of WBC of bacteria infection group and pneumonia mycoplasma group are significantly higher than those of normal group, t-examinations show significant difference between the two groups and normal group （P〈0.05）, show no significant difference between virus infection group and normal one （P〉0.05）. The level of CRP of 61 pediatric patients whose CRP〉5.0mg/L descends significantly after treatment with antibiotic, t-examinations to CRP and WBC before and after treatment show significant difference for CRP （P〈0.05）, show no significant difference for WBC （P〉0.05）. Conclusions CRP is the sensitive but non-special sign in discriminating bacteria infection, mycoplasma infection and virus infection.CRP can be used to guide the clinical reasonable use of antibiotics and judge the curative effect.