C-反应蛋白检测在小儿支原体肺炎急性感染中的价值

Value of C-reactive protein detection in children with acute mycoplasma pneumonia infection

目的探讨C-反应蛋白(CRP)检测在小儿肺炎支原体肺炎(MPP)急性感染中的价值,以利于临床评估病情、防止病情恶化、选择治疗方案、判定疗效。方法将169例MPP患儿分为全身炎性反应综合征(SIRS)组和非SIRS组,SIRS组中符合小儿SIRS诊断标准2项者为SIRS1组,符合3项以上者为SIRS2组。分别于入院当天或第2天、1周后检测血清CRP。结果入院时CRP均值各组均增高,增加值SIRS两组大于SIRS1组大于非SIRS组(P<0.01)。治疗1周后,各组CRP指标较入院时均明显下降,非SIRS组与正常值比较无差别(P>0.05),但SIRS2组仍高于SIRS1组和非SIRS组(P<0.01);其中本组MPP患儿中入院时CRP升高者中,3岁以下儿童占总数的56.5(39/69),3岁以上儿童为43.5(30/69),其中最小的为生后30d。结论 CRP是MPP急性期炎症反应的敏感检测指标,动态监测CRP可判断MPP病情轻重、帮助预测发生并发症及混合细菌感染的可能及选择治疗方案、判断治疗效果;且MPP急性感染在婴幼儿中并不少见,有向低龄化发展的趋势,值得临床工作者重视。

Objective To study the value of C-reactive protein （CRP） detection in children with myeoplasma pneumoniae （MPP） infection,in order to facilitale the clinical evaluation of disease, prevention of disease progression, the choice of treatment programs,and determination of clinical efficacy. Methods 169 MPP children were divided into systemic inflammatory response syn drome （SIRS） group and non SIRS group. Children of SIRS group met two diagnostic criteria of SIRS were divided into SIRS1 group,and children of SIRS group met more than two diagnostic criteria were divided into SIRS2 group. Serum CRP levels were detected on the admission day or the next day,and a week later,respectively. Results Mean CRP levels of each group on admission were significantly increased,and the order of the value of these groups from high to low was： SIRS 2〉SIRS 1〉non SIRS （P〈 0.01）. After a week＇s treatment,each group＇s CRP level was significantly decreased comparing with the admission day. Non-SIRS group＇s CRP level was the same with norma! value （P〉0.05）, however,SIRS2 group＇s CRP level was still higher than SIRS1 group＇s and non SIRS group＇s （P〈0.01）. Among 69 MPP children whose CRP level were increased on admission,39 children （56. 50/00） were younger than 3 years old,30 children （43.5%） were 3 years old or older than 3,and the youngest of them was only 30 days. Conclusion CRP is the sensitive detection target of acute phase inflammatory response of MPP. Dynamic monitoring of CRP should be helpful to judge MPP,predict complications and mixed bacterial infection, and select possible treatment options. MPP acute infection in infants and young children was not rare,and there was a developing trend in younger age. It was worth attention of clinical workers.