小儿肺炎支原体肺炎合并全身炎症反应综合征时超敏CRP、PCT、WBC变化及临床意义研究

Changes and clinical significance of hypersensitive CRP,PCT and WBC in children with mycoplasma pneumoniae pneumonia complicated with systemic inflammatory response syndrome

目的探讨超敏C-反应蛋白(hs-CRP)、外周血白细胞(WBC)和降钙素原(PCT)的变化与合并全身炎症反应综合征(SIRS)的小儿肺炎支原体肺炎(MPP)的关系,以明确其对临床病情评估、疗效判定的意义。方法选取2016年1月—2017年12月蚌埠市第一人民医院收治的小儿肺炎支原体肺炎患儿共计104例,根据是否合并全身炎症反应综合征分为合并组和非合并组,每组患儿均为52例,将合并组患儿根据病情轻重分为重度组和轻度组各26例,对各组患儿均进行hs-CRP、PCT及WBC的检测。结果合并组患儿治疗后较治疗前的hs-CRP(P<0.001)、PCT(P=0.007)、WBC(P<0.001)均有下降,且差异均有统计学意义;未合并组治疗后较治疗前仅PCT(P=0.008)有下降,差异有统计学意义;重度组治疗后较治疗前的hs-CRP(P<0.001)、PCT(P=0.007)、WBC(P<0.001)均有下降,差异有统计学意义;轻度组治疗后较治疗前的hs-CRP(P=0.002)、WBC (P<0.001)有下降,差异有统计学意义;重度组第三代头孢及糖皮质激素应用率(69.2%、76.9%)均高于轻度组(30.8%、38.5%),差异有统计学意义(均P<0.05)。结论小儿肺炎支原体肺炎合并全身炎症反应综合征时检测其hsCRP、PCT、WBC,可帮助判断病情轻重、疗效及预后。

Objective To explore the relationship between the changes of inflammation-associated factors,hypersensitive C-reactive protein(hs-CRP),WBC,procalcitonin(PCT),and the mycoplasma pneumonia(MPP) combined with systemic inflammatory response syndrome(SIRS) in children.To clarify the significance of clinical condition evaluation and therapeutic effect assesment.Methods A total of 104 children with Mycoplasma pneumoniae pneumonia,from January2016 to December 2017,at Bengbu First People’s Hospital were selected,52 cases with concomitant SIRS and 52 cases without SIRS.The 52 cases with concomitant SIRS were then divided into severe group(26 cases) and mild group(26cases) according to the severity of the disease.The levels of hs-CRP,WBC,and PCT in all cases were detected.Results Compared to the data of before the treatment,hs-CRP(P < 0.001),PCT(P = 0.007),and WBC(P < 0.001)were decreased after treatment in the group with concomitant SIRS,and the difference was statistically significant.However,in the group without concomitant SIRS,only PCT(P = 0.008) was decreased compared to the data of before the treatment,and the difference was statistically significant.After treatment in severe groups,hs-CRP(P < 0.001),PCT(P = 0.007),and WBC(P < 0.001) were all decreased compared to the data of before the treatment,and the difference was statistically significant.After treatment in mild groups,hs-CRP(P = 0.002) and WBC(P < 0.001) were decreased,and the difference was statistically significant.In the group with concomitant SIRS,the application rate of third generation cephalosporin and glucocorticoid in severe group(69.2%,76.9%) was higher than that in mild group(30.8%,38.5%),and the difference was statistically significant(all P < 0.05).Conclusion The detection of hsCRP,PCT,and WBC in children with Mycoplasma pneumonia combined with systemic inflammatory response syndrome could help determine the severity,therapeutic efficacy,and prognosis of the disease.