降钙素原与C-反应蛋白在小儿重症肺炎早期诊断中的价值

Value of procalcitonin and C-reactive protein in early diagnosis of children severe pneumonia

目的:探讨降钙素原(procalcitonin,PCT)与C反应蛋白(C-reaction protein,CRP)在小儿重症肺炎早期诊断中的价值。方法:对我院87例重症肺炎患儿根据病原学检测分为3组,即细菌性肺炎组、病毒性肺炎组、支原体肺炎组,另选取我院体检中心20例同期无感染的健康儿童为对照组,对3组小儿重症肺炎87例和20例健康对照组的血清同时进行PCT、CRP、WBC 3项平行检测,并做对比分析。结果:细菌性肺炎组PCT、CRP、WBC 3项结果均明显高于对照组,支原体肺炎组PCT、CRP 2项结果均明显高于对照组,病毒性肺炎组PCT、CRP、WBC 3项结果均与对照组相近;PCT在细菌性肺炎组血清水平明显高于其他组,阳性率为94.2%,CRP在细菌性肺炎组、支原体肺炎组血清水平明显高于病毒性肺炎组,阳性率分别为97.1%、92.8%,病毒性肺炎组PCT、CRP血清水平均未出现明显增高。结论:PCT、CRP在重症肺炎早期诊断中有较高的阳性检出率,可作为重症肺炎早期鉴别诊断指标。PCT、CRP均增高为细菌性肺炎,单独CRP增高为支原体肺炎;PCT、CRP均不增高可能为病毒性肺炎。

Objective：To discuss the value of procalcitonin（PCT） and C-reactive protein（CRP） in early diagnosis of children severe pneumonia.Methods：87 children patients with severe pneumonia in our hospital were divided into three groups according to pathogen detection： bacterial pneumonia group,viral pneumonia group and mycoplasma pneumonia group.20 healthy children from the medical examination center of our hospital were chosen as the control group.The results of serum PCT,CRP and WBC in four groups were compared.Results：The levels of PCT,CRP and WBC in bacterial pneumonia group were significantly higher than those in the healthy control group.The levels of PCT and CRP in mycoplasma pneumonia group were significantly higher than those in healthy control group.The levels of PCT,CRP and WBC in viral pneumonia group were close to those in healthy control group.The level of PCT in bacterial pneumonia group was significantly higher than that in other groups,the positive rate was 94.2%.The level of CRP in bacterial pneumonia group and mycoplasma pneumonia group was significantly higher than that in viral pneumonia group,the positive rates were 97.1% and 92.8% respectively.Both PCT and CRP in viral pneumonia group were not obviously increased.Conclusion：PCT and CRP in early diagnosis of severe pneumonia have higher positive rate,which can be used as early differential diagnostic indicator in severe pneumonia.Both the levels of PCT and CRP are increased in bacterial pneumonia.The level of CRP alone is increased in mycoplasma pneumonia.Neither of the levels of PCT and CRP is increased in viral pneumonia.