探讨PCT和C-反应蛋白联合检测在小儿不同类型肺炎诊断中的应用

Discussion on applilation of PCT ang C-reactive protein combined defection in diagnosis of chicdren different types pneumonia

目的：探讨血清降钙素原（PCT）和C-反应蛋白联合检测在小儿不同类型肺炎鉴别及诊断中的临床应用，为临床应用抗生素提供重要依据。方法：随机选择2013年2月-2013年11月期间在我院儿科治疗小儿不同类型肺炎的患者78例，均对其采集血清标本，其中细菌性肺炎39例，病毒性肺炎32例，支原体肺炎7例，用免疫荧光法检测其血清PCT浓度，采用免疫比浊法检测血清CKP浓度。结果：小儿细菌感染组其血清PCT的阳性率与其他两组比较，P〈0．05，差异有显著性意义；组内PCT和CRP阳性率比较，细菌感染组和支原体感染组中，两种阳性率的差异比较，P〉0．05无统计学意义；病毒感染组中，两种阳性率的差异比较，P〈0．05，有显著性意义；对照组中，两种阳性率的差异有显著性意义（P〈0．01）。细菌感染组患者血清中的PCT的水平均高于病毒感染组和支原体感染组，且P〈0．01，差异有显著性意义。结论：血清PCT测定有助于小儿肺炎的诊断及鉴别诊断，可作为临床抗生素的使用依据。提高使用抗生素安全性，有效避免二重感染。同时在鉴别细菌感染与病毒、支原体感染时，PCT优于CRP,其能有效地发现早期重症感染。

Objective ： To study the serum calcitonin （PCT） and C - reactive protein joint detection In the diagnosis of pediatric pneumonia identification and clinical applications, provide important basis for the clinical application of antibiotics. Methods ： Randomly selected from February 2013 to November 2013 in our hospital during the period of treatment of 78 patients with infantile pneumonia in pediatrics, both serum samples to its, 39 cases of bacterial pneumonia, viral pneumonia 32 cases, 7 cases of mycoplasma pneumonia, with immunofluorescence method to detect the serum PCT concentrations, immune turbidimetric method is used to detect serum CRP concentration.Results ： The positive predictive value of serum PCT pediatric bacterial infection group compared with other two groups, P 〈 0.05, significant difference; Positive predictive value of PCT and CRP in the group, bacterial infection and mycoplasma infection group, the differences of two positive rate comparison, no statistical significance （P〉0.05; Virus infection group, compared the differences of two positive rate, P〈 0.05, significant meaning; In the control group, the differences of two positive rate has a significant meaning （P〈0.01）. Serum PCT level in patients with bacterial infection group were higher than that of virus and mycoplasma infection group, and P〈0.01, significant difference.. Conclusions ： The determination of serum PCT help diagnosis and differential diagnosis of infantile pneumonia, can be taken as the basis of clinical use of antibiotics .