降钙素原在儿童CAP肺炎中的临床价值研究

Research on Clinical Value of Procalcitonin in the CAP Pneumonia in Children

目的探讨降钙素原在儿童CAP中的临床价值。方法回顾性收集2016年1—6月苏州吴中人民医院住院CAP患儿102例,将其按照所患疾病种类进行分组,其中细菌性肺炎组40例、病毒性肺炎组29例、支原体肺炎组33例;并与35名健康儿童进行比较,称为正常对照组;对比各组外周血PCT检测结果及阳性数。将102例肺炎患者按照严重程度分组,分别为重症肺炎组37例,非重症肺炎组65;对比两组PCT与脏器功能指标的关系。结果血清PCT水平与hs-CRP、WBC计数、中性粒细胞比率(NEUT%)呈正相关(P<0.01);细菌性肺炎患儿的PCT水平、PCT阳性率分别为(6.04±1.28)ng/m L、92.50%,均高于支原体肺炎和病毒性肺炎患儿(P<0.01);病毒性肺炎和支原体肺炎患儿PCT阳性率分别为3.40%、12.12%,与正常对照儿童比较,差异无统计学意义(P>0.05);重症肺炎组和非重症肺炎组患儿比较,重症肺炎组患儿的PCT水平、PCT阳性率均明显更高,差异有统计学意义(P<0.01);脏器功能损伤时PCT水平明显升高(P<0.01)。结论 PCT水平用于早期鉴别肺炎病原类型,其价值优于hsCRP、WBC等,且在判断肺炎严重程度、预测脏器损伤的发生方面具有重要意义。

Objective To discuss the clinical value Of procalcitonin in the CAP pneumonia in children. Methods 102 cases of CAP children treated in our hospital from January to June 2016 were selected and divided into the bacterial pneumonia group with 40 cases, virus pneumonia group with 29 cases and primary atypical pneumonia group with 33 cases according to the disease type, and 35 cases of healthy children were selected as the normal control group, and the peripheral blood PCT test results and positive number were compared in each group, and 102 cases of patients with pneumonia were divided into the severe pneumonia group with 37 cases and non-severe pneumonia group with 65 cases according to the severity, and the correlation between PCT and organ function indicator was compared between the two groups. Results The serum PCT level was positively correlated with the hs-CRP, WBC count and NEUT% （P〈 0.01 ）, and the PCT level and PCT positive rate of children with bacterial pneumonia were respectively （6.04±1.28）ng/ mL and 92.50%, which were higher than those of children with primary atypical pneumonia and virus pneumonia（P〈 0.01 ）, and the PCT positive rate of children with virus pneumonia and primary atypical pneumonia was respectively 3.40% and 12.12%, and the differences between groups had no statistical significance（P〉0.05）, and the PCT level and PCT positive rate of children with severe pneumonia was higher, and the differences were obvious with statistical significance（P〈0.01）, and the PCT level at the time of organ function injury obviously increased（P〈0.01）. Conclusion The value of PCT level in the early diagnosis of pneumonia pathogen type is better than hs-CRP and WBC, and it is of important significance to the judgement of severity of pneumonia and predication of organ injury.