血清降钙素原、C-反应蛋白、前清蛋白及白细胞计数联合检测在小儿重症肺炎诊断中的临床价值

Procalcitonin, CRP, prealbumin, and WBC in diagnosis of children with severe pneumonia

目的探讨血清降钙素原（PCT）、C-反应蛋白（CRP）、前清蛋白（PA）及白细胞计数（WBC）联合检测在小儿重症肺炎诊断中的临床价值。方法选取本院2015年3月至2016年9月收治的105例重症肺炎患儿，根据感染病原体的不同分为支原体感染组（34例）、病毒感染组（34例）和细菌感染组（37例），另选同期体检健康儿童30例为对照组。检测并比较各组受检者血清PCT、CRP、PA、WBC水平的差异。结果对照组儿童血清PCT、CRP、WBC水平均明显低于重症肺炎患儿（t1=27．099，t2=33．273，t3=24．893，均P〈0．05），血清PA水平明显高于重症肺炎患儿（t=10．307，P〈0．05）；支原体感染组患儿血清PCT、CRP、WBC水平均明显高于病毒感染组（t1=26．840，t2=15．360，t3=15．768，均P〈0．05），血清PA水平明显低于病毒感染组（t=4．912，P〈0．05）；细菌感染组患儿血清PCT、CRP、WBC水平均明显高于支原体感染组（t1=8．276，t2=4．219，t3=10．982，均P〈0．05），血清PA水平明显低于支原体感染组（t=12．871，P〈0．05）；细菌感染组患儿血清PCT、CRP、PA、WBC阳性率均明显高于支原体感染组（χ21=8．272，χ22=9．234，χ23=11．992，χ24=6．406，均P〈0．05），支原体感染组患儿血清PCT、CRP、PA、WBC阳性率均明显高于病毒感染组（χ21=19．125，χ22=3．985，χ23=3．985，χ24=3．886，均P〈0．05）。结论PCT、CRP、PA及WBC联合检测不仅可作为小儿重症肺炎的重要临床诊断指标，还能有效预测感染病原体的种类，对于小儿重症肺炎的临床诊治具有较高的临床指导价值。

Objective To investigate the value of procalcitonin, CRP, prealbumin, and WBC in the diagnosis of children with severe pneumonia. Methods 105 children with severe pneumonia treated at our hospital from March 2015 to September 2016 were divided into a mycoplasma infection group （34 cases）, a viral infection group （34 cases）, and a bacterial infection group （37 cases）. 30 healthy children were selected as a control group. The serum levels of PCT, CRP, PA, and WBC were detected and compared between these four groups. Results The serum levels of PCT, CRP, and WBC were significantly lower and the serum LA level was higher in the control group than the severe pneumonia group （t1=27.099, t2=33.273, t3=24.893, t4=10.307, all P 〈 0.05）. The serum levels of PCT, CRP, and WBC were significantly higher and the serum PA level was significantly lower in the mycoplasma infection group than in the virus infection group （t1=26,840, t2= 15.360, t3= 15.768, t4=4.912, all P 〈 0.05）. The serum levels of PCT, CRP, and WBC were significantly higher and the serum PA level was significantly lower in the bacterial infection group than in the mycoplasma infection group （t1=8.276, t2=4.219, t3=10.982, t4=12.871, all P 〈 0.05）. The positive rates of serum PCT, CRP, PA, and WBC were significantly higher in the bacterial infection group than the mycoplasma infection group （χ21=8.272, χ22=9-234, χ23=11.992, χ24=6-406, all P 〈 0.05）. The positive rate of serum PCT, CRP, PA, and WBC were signifcantly higher in the Mycoplasma infection group than in the viral infection group （χ21=19-125, χ22=3.985, χ23=3.985, χ24=3.886, all P 〈 0.05）. Conelus｜ons The combined detection of PCT, CRP, PA, and WBC can be used as an important diagnostic index for severe pneumonia in children and effectively predict the types of infectious pathogens. It has a higher clinical guidance value in the diagnosis and treatment of severe pneumonia in children.