C反应蛋白检测对感染性肺炎鉴别诊断的价值

The value of C-reactive protein in the differential diagnosis of infectious pneumonia

目的探讨C反应蛋白（CRP）检测对感染性肺炎鉴别诊断的价值。方法将经过细菌培养等检测方法已明确所患肺炎类型的428例感染性肺炎患者分成3组，其中细菌感染患者195例，支原体感染患者118例，病毒感染患者115例。所有患者均采用自动免疫散射速率比浊法测定CRP。观察比较各组患者CRP阳性率的变化。结果3组患者急性期CRP阳性率分别为83.1％、77.3％及13.9％。与急性期相比，细菌感染组和支原体感染组康复后CRP阳性率显著降低，差异有统计学意义（P〈0.01），而病毒感染组却无明显变化，差异无统计学意义（P〉0.05）。结论CRP在细菌和支原体感染时随病情加重而明显升高，随病情恢复而显著下降；但在病毒感染时则无明显，有助于临床早期对感染性肺炎的鉴别诊断，能作为临床用药的一个指导性指标。

Objective To investigate the value of C-reactive protein（CRP） in the differential diagnosis of infec- tious pneumonia. Methods After the use of various methods, such as bacterial culture, the 428 cases of infectious pneumonia patients has been clear the type for pneumonia were divided into three groups, 195 patients in which bacte- ria infection, mycoplasma infection in 118 patients, 115 patients with virus infection. CRP was determined with active immunity scattering velocity turbidimetric method in all patients. To observe the change of positive rate in diferent group. Results CRP positive rate of the 3 groups of patients in acute stage were 83.1%, 77.3% and 13.9%. Com- pared with the acute stage, CRP positive rate in convalescence stage in bacterial infection group and mycoplasma in- fection group decreased markedly （P〈0.01）, and there was no significant change in viral infection group （P〈0.05）. Conclusion In bacterial infection group and mycoplasma infection group,CRP increased significantly when the state of ilness became more serious,and decreased significantly when the state of illness recovered, but when pa- tients were infected with viral is not obvious, those contribute to the early clinical differential diagnosis of pneumonia,can be used as a guidance of clinical application.