难治性肺炎支原体肺炎患儿C反应蛋白检测的临床意义

Clinical significance of CRP detection in children with RMPP

目的探讨难治性肺炎支原体肺炎(RMPP)患儿C反应蛋白(CRP)检测的临床意义。方法回顾性分析2010年6月-2013年5月43例RMPP患儿(观察组)及51例普通肺炎支原体肺炎(MPP)患儿(对照组)的CRP,对2组患儿的白细胞计数(WBC)、中性粒细胞比率(NE%)、血沉(ESR)、影像学特征及发热等情况进行比较分析。结果入院时2组CRP差异有统计学意义(P<0.01),观察组明显高于对照组,治疗1周后观察组仍明显高于对照组(P<0.01);观察组患儿CRP峰值高,持续时间长,而对照组MPP患儿峰值低,治疗后迅速下降,差异有统计学意义(P<0.01);且观察组肺部影像学表现为大片实变等的比例明显高于对照组,差异有统计学意义(P<0.01)。结论 CRP可作为MPP急性期的一个敏感指标,可早期判断或预测RMPP病情轻重、是否发生合并症及混合细菌感染的可能。

Objective To explore the clinical significance of testing refractory mycoplasma pneumoniae pneumonia（ RMPP） and child＇s C reactive protein（ CRP）. Methods A retrospective analysis and comparison,from 2010 June to 2013 May,were performed on 43 cases of RMPP patients（ observation group） and 51 cases of normal mycoplasma pneumoniae pneumonia（ MPP）patients＇（ control group） CRP. The detection results of white blood cell count（ WBC）,the ratio of neutrophils（ NE%）,erythrocyte sedimentation rate（ ESR） of the two groups were simultaneously compared with imaging comparative analysis and heating test results. Results The differences of CRP in 2 groups had statistical significance at the beginning of hospitalization（ P〈0. 01）,that in observation group was significantly higher than that in the control group,and that of observation group,after 1 week of treatment,was still higher than that of control group（ P〈0. 01）; the CRP peak in the observation group was high,and of long duration,while in the control group of children,CRP peak was low,and MPP,after treatment,decreased rapidly,the difference had statistical significance. And the pulmonary imaging in observation group showed a large consolidation ratio,which was significantly higher than that of the control group,the difference was statistically significant（ P〈0. 01）; although the differences of ESR,WBC and NE% in the two groups at the beginning of hospitalization were statistically significant（ P〈0. 01）,and the observation group was higher than the control group,after 1 week of treatment,the changing differences of the 2 groups were not big（ P〉0. 05）. Conclusion CRP can be used as a sensitive indicator of MPP in acute stage,and performed on the early diagnosis or prediction of RMPP severity,as well as the possibility of whether mixed bacterial infections and complications. If CRP increased significantly and does not retreat continuously,after the treatment of the regular anti mycoplasma 1 week,when the sustained high fever,and lung imaging are making progress,glucocorticoid and third generation cephalosporin resistance to infection must be timely used to avoid the occurrence of serious complications.