血清C-反应蛋白及WBC水平在儿童发热性疾病中的意义

The diagnostic significance of the detection of serum C-reaction protein and WBC in children with febrile diseases

目的探讨发热患儿血清C-反应蛋白（CRP）及WBC水平在儿童发热性疾病中的临床意义。方法选择2014年1~12月重庆市涪陵区妇幼保健院儿科收治的176例发热患儿的病历资料,采取回顾性分析方法,根据出院时的诊断结果,将其分为细菌感染组（81例）、病毒感染组（72例）和风湿性疾病组（23例）。同时将同期在重庆市涪陵区妇幼保健院体检的自愿参加本研究的健康儿童纳入健康对照组（38例）。对3组疾病组受试儿童血清CRP及WBC水平与健康对照组进行统计学比较。4组受试儿童年龄、性别、发热病程、营养状况及合并其他疾病等比较,差异无统计学意义（P〉0.05）。结果与健康对照组相比较,细菌感染组CRP与WBC计数均显著升高,差异有统计学意义（P〈0.05）;病毒感染组CRP与WBC计数与健康对照组比较,差异无统计学意义（P〉0.05）;风湿性疾病组CRP较健康对照组升高明显,差异有统计学意义（P〈0.05）,WBC略有升高,但是差异无统计意义（P〉0.05）。细菌感染组CRP（＋）与WBC（＋）63例,占77.78%（63/81）,病毒感染组CRP（-）与WBC（-）70例,占97.22%（70/72）,风湿性疾病组CRP（＋）与WBC（-）18例,占78.26%（18/23）。结论 CRP及WBC联合检测在小儿发热性疾病的鉴别诊断中具有重要意义。

Objective To investigate the clinical significance of the detection of serum C-reactive protein（CRP）in children with febrile diseases.Methods 176 cases of children with febrile diseases admitted in Women and Children s Health Care Hospital of Fuling District from January 2014 to December 2014 were enrolled in the study,and their clinical data were retrospectively analyzed.According to their diagnosis results at discharge,the children were divided into bacterial infection group（n=81）,viral infection group（n=72）,and rheumatic disease group（n=23）.At the same time,38 cases of healthy children who had physical examination in Women and Children s Health Care Hospital of Fuling District and voluntarily participated in the study were enrolled as normal control group.There was no difference of age,sex ratio,duration of fever,nutritional status,and complication among 4groups（P〈0.05）.The levels of CRP and WBC of 3disease groups were compared with those of normal control group.ResultsComparing with normal control group,the levels of CRP and WBC in bacterial infection group were significantly increased,and the difference was statistically significant（P〈0.05）;there was no difference of CRP and WBC between viral infection group and normal control group（P〈0.05）;The CRP level of rheumatic disease group was significantly higher than that of normal control group（P〈0.05）,however,the WBC level of rheumatic disease group was a little higher than that of normal control group,but the difference was not significant（P〉0.05）.In bacterial infection group,there were 63 cases of patients with CRP（＋）WBC（＋）,accounting for 77.78%（63/81）.In viral infection group,there were 70 cases of patients with CRP（-）WBC（-）,accounting for 97.22%（70/22）.In rheumatic disease group,there were 18 cases of patients with CRP（＋）WBC（-）,accounting for 78.26%（18/23）.Conclusion The combined detection of CRP and WBC had important value in the differential diagnosis of pediatrics febrile diseases.