应用CRP和PCT检测对儿童下呼吸道感染早期诊断的价值

CRP and PCT test value for early diagnosis of children's lower respiratory infection

目的 探讨应用C反应蛋白（CRP）和血清降钙素原（PCT）检测对儿童下呼吸道感染早期诊断的价值.方法 选择2011年2月～2013年2月浙江省温岭市第一人民医院儿科病房下呼吸道感染性疾病患儿120例为研究对象,其中细菌感染组60例,病毒感染组60例,选择同期体检的无呼吸系统病症及其他相关感染性疾病的健康儿童（健康组）60名,对三组儿童进行细菌培养和肺炎支原体抗体检测,并于0、3、7d及14 d行静脉血PCT、CRP检测.结果 随着抗生素的使用治疗,细菌感染组0、3、7、14 d PCT的总阳率（85.0％、56.7％、26.7％、11.7％）及CRP的阳性率（90.0％、80.0％、45.0％、21.7％）均逐渐降低,且治疗3、7、14 d PCT的总阳率与0d比较,差异均有统计学意义（P＜ 0.05或P＜0.01）,治疗后7、14 d CRP的阳性率明显低于0d,差异有统计学意义（P＜0.05）.结论 CRP及PCT均可作为儿童下呼吸道感染的早期诊断指标,但PCT在病情治疗反应上优于CRP.针对条件较差、无法开展病原学检查的基层医院,可采用CRP替代PCT来诊断儿童下呼吸道感染.

Objective To explore the application of procalcitonin （PCT） and creactive protein （CRP） detection value for early diagnosis of children＇s lower respiratory infection.Methods 120 cases of children with lower respiratory tract infections were collected in the pediatric ward of the First People＇s Hospital of Wenling City in Zhejiang Province from February 2011 to February 2013,and bacterial infections group with 60 cases,virus infected group with 60 cases,60 cases of healthy children to hospital physical examination without respiratory symptoms and other related infectious diseases （health group） in the same period were selected.Bacteria cultivation and mycoplasma pneumoniae antibody detection were carried among three groups,PCT and CRP of venous blood in 0,3,7 d,and 14 days were detected.Results With the use of antibiotic treatment,the PCT positive rate of bacterial infections group （85.0%,56.7%,26.7%,11.7%） and CRP positive rate （90.0%,80.0%,45.0%,21.7%） in 0,3,7,14 days after treatment were reduced gradually,and the positive rate of PCT in 7,14 days after treatment were lower than that in 0 day,the differences were statistically significant （P 〈 0.05 or P 〈 0.01）.The CRP positive rate in 7,14 days after treatment were lower than that in 0 day （P 〈 0.05）.Conclusion CRP and PCT can be as indicators in the early diagnosis of children＇s lower respiratory infection,but the PCT is superior to CRP in disease treatment response.In view of the basic-level hospitals with poor conditions,unable to carry out etiology examination,CRP can be used instead of PCT to diagnose children＇s lower respiratory infection.