C-反应蛋白检测在小儿肺炎中的诊断价值

Value of detection of C-reactive protein in diagnosis of pneumonia in children

目的探讨C-反应蛋白(CRP)检测用于诊断小儿肺炎的临床价值。方法选取2010年5月-2011年5月医院收治的120例小儿肺炎患者作为研究对象,按照其肺炎类型将其分为细菌性肺炎组、病毒性肺炎组及支原体肺炎组,选择同期行健康体检的50例幼儿作为对照组,对3组患儿就诊时的白细胞(WBC)、C-反应蛋白指标进行测定,同期检测对照组幼儿的上述指标,比较3组患儿上述两个指标的差异,并与对照组幼儿进行比较;按照其相应的阳性诊断标准计算WBC、CRP的阳性检出率并比较,综合评价CRP在小儿肺炎诊断中的价值。结果经研究显示,细菌性肺炎组、病毒性肺炎组、支原体肺炎组患儿及对照组幼儿就诊时的WBC分别为(11.7±4.1)、(9.5±3.0)、(9.0±3.1)及(7.0±2.2)×109/L;CRP分别为(52.3±24.0)、(9.1±3.3)、(34.7±13.4)及(3.9±2.1)mg/L,组间比较,细菌性肺炎组、病毒性肺炎组及支原体肺炎组的CRP及WMC均明显高于对照组,细菌性肺炎组又明显高于病毒性肺炎组和支原体肺炎组,上述组间比较差异均有统计学意义(P<0.05);细菌性肺炎组、病毒性肺炎组、支原体肺炎组患儿的WBC检测阳性率分别为81.3%、77.5%、66.5%,CRP的阳性检出率分别为100.0%、74.5%、73.4%,CRP对细菌性肺炎的检出率明显高于WBC,比较差异有统计学意义(P<0.05)。结论 CRP具有取材简单、快速、对细菌性肺炎阳性检出率高的优势,在排除患儿其他导致CRP升高的因素前提下,不失为一种有效鉴别肺炎的诊断方法。

OBJECTIVE To explore the clinical value of the detection of C-reactive protein in the diagnosis of pneumonia in children.METHODS A total of 120 cases of pediatric patients with pneumonia treated hospital from May 2010 to May 2011 were chosen as the research objects,according to the types of pneumonia,they were divided into bacterial pneumonia group,viral pneumonia group,and Mycoplasma pneumonia group;totally 50 healthy children receiving physical examination at the same period were chosen as the control group;the white blood cells and C-reactive protein indicators of three groups of children were determined as they were treated,the indicators mentioned above were also detected for the control group at the same period;the differences in the two indicators mentioned above among the 3 groups were compared with the control group;the positive rates for WBC and CRP were calculated and compared in accordance with its corresponding positive diagnostic criteria;the value of CRP in the diagnosis of pneumonia in children was comprehensively evaluated.RESULTS The study showed that WBC of the bacterial pneumonia group,viral pneumonia group,children with Mycoplasma pneumonia group,and the control group,as receiving the treatment,were（11.7 ± 4.1）,（9.5±3.0）,（9.0±3.1）,and（7.0±2.2） ×109/L;CRP were respectively（52.3±24.0）,（9.05±3.3）,（34.7 ± 13.4）,and（3.9 ± 2.1） mg/L;both CRP and WMC of bacterial pneumonia group,viral pneumonia,Mycoplasma pneumonia group were significantly higher than those of the control group;the CRP and WBC of bacterial pneumonia group were significantly higher than those of viral pneumonia group and Mycoplasma pneumonia group,the difference was statistically significant（P0.05）.the positive rates of WBC of the children in bacterial pneumonia group,viral pneumonia group and Mycoplasma pneumonia group were 81.3%,77.5%,and 66.5%,respectively,the positive rates of CRP were 100.0%,74.5%,and 73.4%,respectively,the detection rate of CRP of bacterial pneumonia group was significantly higher than that of WBC,the differences were statistically significant（P0.05）.CONCLUSION CRP has the advantages of simple sampling,rapidness,high positive detection rate of bacterial pneumonia rate.It is an effective method to differentiate the pneumonia on the basis of ruling out the factors that lead to elevated CRP.