肺炎患儿外周血超敏C反应蛋白、降钙素原及T细胞免疫指标变化及意义

Changes and significance of high sensitivity C reactive protein,procalcitonin and T cell immune index of peripheral blood in children with pneumonia

目的探讨肺炎患儿外周血超敏C反应蛋白、降钙素原及T细胞免疫指标变化及意义。方法选取2013年8月~2014年8月我院进行治疗的肺炎患儿95例,包括细菌性肺炎35例,支原体肺炎32例,病毒性肺炎28例,同时选取正常体检儿童25例作为对照组。对四组外周血超敏C反应蛋白、降钙素原及T细胞免疫指标进行测定。结果细菌性肺炎及支原体肺炎患儿外周血hs-CRP水平明显高于对照组（P〈0.05）。病毒性肺炎组患儿外周血hs-CRP水平与对照组比较差异无统计学意义（P〉0.05）。细菌性肺炎患儿PCT水平及阳性数显著高于其他三组（P〈0.05）。支原体肺炎及病毒性肺炎患儿PCT与对照组比较,差异无统计学意义（P〉0.05）。细菌性肺炎、支原体肺炎、病毒性肺炎CD4＋,CD4＋/CD8＋、CD4＋CD25＋Treg与对照组比较,差异皆有统计学意义（P〈0.05）。细菌性肺炎组、支原体肺炎组CD8＋与对照组比较,差异皆有统计学意义（P〈0.05）。结论肺炎患儿存在细胞免疫失调,在临床检测中可以把hs-CRP、PCT作为鉴别患儿不同类型肺炎的指标。

Objective To explore the changes and significance of high sensitivity C reactive protein,procalcitonin and T cell immune index of peripheral blood in children with pneumonia. Methods 95 children with pneumonia from 2013 August to 2014 August in our hospital were treated,including 35 cases of bacterial pneumonia,32 cases of mycoplasma pneumonia,28 cases of viral pneumonia,and 25 cases of normal children were selected as control group.The high sensitivity C reactive protein,procalcitonin and T cell immune indexes of peripheral blood in four groups were determined. Results The level of hs-CRP in peripheral blood of bacterial pneumonia and mycoplasma pneumonia were significantly higher than the control group（P〈0.05）.The difference was not statistically significant in the hs-CRP level of peripheral blood between the viral pneumonia group and the control group.The level and positive of PCT in children with bacterial pneumonia were significantly higher than the other three groups（P〈0.05）.The difference was not statistically significant in the level and positive of PCT among mycoplasma pneumonia group,viral pneumonia group and control group（P〉0.05）.The CD4＋,CD4＋/CD8＋,CD4＋CD25＋ and Treg in bacterial pneumonia group,mycoplasmapneumonia group and viral pneumonia group had statistically significant difference compared with the control group（P〈0.05）.The difference had statistical significance in the CD8＋ among bacterial pneumonia group,mycoplasma pneumonia group and control group（P〈0.05）. Conclusion Children with pneumonia have cellular immune dysfunction,hs-CRP,PCT in clinical can be used to identify different types of children＇s pneumoniaindex.