肺炎患儿血清降钙素原和C反应蛋白水平变化和意义

Clinical significance of serum procaleitonin and C -reactive protein testing for pneumonia

目的：探讨肺炎患儿血清降钙素原（PCT）和CRP水平的变化和临床意义。方法选择123例肺炎患儿，其中细菌感染48例、支原体感染36例、病毒感染39例，另选同期40例体检健康儿童作为对照组。分别检测其血清 PCT 和 CRP 含量，对检测结果与临床最后诊断的相关性进行分析。结果细菌性肺炎组、支原体肺炎组和病毒肺炎组 PCT 的水平分别为（5．80±1．92）μg／L、（0．45±0．15）μg／L 和（0．32±0．17）μg／L，明显高于对照组的（0．19±0．10）μg／L（t ＝5．37、3．41、1．23，均 P ＜0．05）；细菌性肺炎组、支原体肺炎组和病毒肺炎组 CRP 的水平分别为（45．34±13．35）mg／L、（28．63±11．37）mg／L 和（8．19±2．07）mg／L，明显高于对照组的（3．85±1．31）mg／L（t ＝5．37、3．41、1．23，均 P ＜0．05）；血清 PCT 检测肺炎患儿的敏感性、特异性和阳性预测性分别为93．56％、82．35％和69．25％，分别高于血清 CRP 诊断肺炎的敏感性、特异性和阳性预测性（χ2＝4．41、5．83、7．62，均 P ＜0．05）。结论血清 PCT 和 CRP 测定可作为儿童肺炎的辅助鉴别指标，对儿童肺炎的诊断具有重要的临床意义。

Objective To investigate serum procalcitonin（PCT）and C-reactive protein（CRP）and clinical significance of changes in children with pneumonia.Methods 123 cases of childhood pneumonia included 48 cases of bacterial infection,mycoplasma infection in 36 cases,39 cases with viral infections,40 cases of physical healthy children were selected as the control group.They were measured in serum PCT and CRP content of the correlation between test results and analysis of clinical final diagnosis.Results The level of PCT in Bacterial pneumonia group, Mycoplasma pneumonia group and viral pneumonia group were （5.80 ±1.92）μg/L,（0.45 ±0.15 ）μg/L and （0.32 ±0.17）μg/L,respectively,significantly higher than control group（0.19 ±0.10）μg/L（t =5.37,3.41,1.23, all P 〈0.05）;the level of CRP in Bacterial pneumonia group,mycoplasma pneumonia group and viral pneumonia group were（45.34 ±13.35 ）mg/L,（28.63 ±11.37）mg/L and （8.19 ±2.07）mg/L,respectively,significantly higher than control group（3.85 ±1.31）mg/L（t =5.37,3.41,1.23,all P 〈0.05）;serum PCT sensitivity to detect pneumonia children,specificity and the positive predictive were 93.56%,82.35% and 69.25%,respectively,higher than serum CRP diagnosis of pneumonia sensitivity,specificity and positive predictive（χ2 =4.41,5.83 and 7.62, respectively,all P 〈0.05）.Conclusion Serum PCT and CRP measurement can be used as an auxiliary to identify indicators of childhood pneumonia,the diagnosis of pneumonia in children has important clinical significance.