降钙素原和C反应蛋白在支气管哮喘合并呼吸道感染中的诊断意义

Diagnostic value of procalcitonin and C-reactive protein in bronchial asthma complicated with respiratory infection

目的探讨血清降钙素原（PCT）和C反应蛋白（CRP）对支气管哮喘急性发作患儿抗生素应用的诊断价值。方法选取60例支气管哮喘急性发作的患儿，根据发病诱因分成过敏诱发组18例、病毒感染诱发组14例及细菌感染诱发组28例，采用免疫荧光法定量测定患儿血清PCT水平，酶联免疫吸附试验测定血清CRP水平。结果细菌感染诱发组患儿血清PCT、CRP水平分别为（25．7±11.2）恤羁，L和（50-3±17．5）mg／L，明显高于病毒感染诱发组和过敏诱发组[（0．7±0．2）μg／L、（6．1±0．3）mg／L和（0．2±0．1）μg／L、（3．5±0．4）mg／L，P〈0．05]；病毒感染诱发组患儿血清PCT、CRP水平与过敏诱发组比较轻度增加，差异无统计学意义（P〉0．05）。细菌感染诱发组患儿血清PCT与CRP水平呈正相关（r=3．612，P〈0．05），病毒感染诱发组和过敏诱发组患儿血清PCT与CRP水平无相关性（r=-0．021、-0．103，P〉0．05）；以CRP10mg／L，PCT≥0．5μg／L为阳性，细菌感染诱发组患儿血清CRP、PCT阳性率分别为89．3％（25／28）和92．9％（26／28），均高于病毒感染诱发组和过敏诱发组[28．6％（4／14）、64．3％（9，14）和22．2％（4／18）、33．3％（6／18），P〈0．05]，且病毒感染诱发组血清PCT、CRP阳性率高于过敏诱发组，差异有统计学意义（P〈0．05）。结论血清PCT、CRP指标能早期正确鉴别细菌感染诱发的支气管哮喘急性发作患儿。

Objective To explore the diagnostic value of serum procalcitonin（PCT） and C-reactive protein （CRP） in using of antibiotics in patients with acute bronchial asthma attack. Methods Sixty cases with acute bronchial asthma attack were divided into allergen-induced group （18 cases）, viral infectioninduced group （14 cases） and bacteria infection-induced group （28 cases）. The serum PCT level was examined by immune luminous method. The CRP level was examined by enzyme linked immune scattered method. Results The serum PCT and CRP level was （25.7 ＋ ll.2）trg/L and （50.3 ± 17.5） mg/L in bacteria infection-induced group, which was significantly higher than that in viral infection-induced group and allergen-induced group [ （ 0.7 ± 0.2 ）μg/L, （6. 1± 0.3 ） mg/L and （ 0.2 ± 0.1 ） μ g/L, （ 3.5 ± 0.4 ） rag/L, P 〈 0.05 ]. There was no significant difference in the serum PCT and CRP level between viral infection- induced group and allergen-induced group （P 〉 0.05 ）. There was positive correlation between PCT and CRP in bacterial infection group （r = 0.932 ,P〈 0.05）, while no correlation existed between PCT and CRP in viral infection-induced group and allergen-induced group （r = -0.021,-0.103,P 〉 0.05）. CRP I〉 10 mg/L and PCT ~〉0.5 ~g/L was as positive criteria. The positive rate of serum CRP and PCT in bacteria infection- induced group was 89.3%（25/28） and 92.9%（26/28）,which was higher than that in viral infection-induced group and allergen-induced group [28.6% （4/14）, 64.3% （9/14） and 22.2% （4/18）,33.3% （6/18） ,P 〈 0.05 ], and the positive rate of serum CRP and PCT in viral infection-induced group was higher than that in allergen-induced group, there was significant difference （P 〈 0.05）. Conclusion The serum PCT and CRP level can correctly identify early bacteria infection patients with acute bronchial asthma attack.