儿童社区获得性肺炎流行病学特点及血清降钙素原水平临床分析

Clinical analysis of epidemiological characteristics and serum procalcitonin levels in children with community acquired pneumonia

目的探讨儿童社区获得性肺炎(CAP)流行病学特点及血清降钙素原水平在肺炎诊断和治疗中的价值。方法选择湖州市第一人民医院2017年1月-6月CAP患儿150例,根据肺炎轻重程度分为2组,检测患者血清降钙素原(PCT)、C-反应蛋白(CRP)水平,分析并比较二者对CAP早期诊断与治疗的影响,比较细菌性肺炎与非细菌性肺炎的早期干预结果。结果细菌性肺炎患儿PCT、CRP水平明显高于非细菌性肺炎患儿,差异有统计学意义(P<0.05);86例细菌性肺炎患者住院第1 d PCT检测阳性率为85.62%,随着治疗的进展,住院第3 d、第5 d PCT阳性率下降为53.27%、32.55%。重度肺炎组中血清PCT、CRP水平均高于轻度肺炎组,差异有统计学意义(P<0.01)。结论血清PCT、CRP水平均能反应儿童社区获得性肺炎治疗效果。

Objective To investigate the value of epidemiological characteristics and serum procalcitonin level of children with community acquired pneumonia（ CAP） in the diagnosis and treatment of pneumonia. Methods 150 patients with CAP collected during January-June 2017 from the First People＇s Hospital of Huzhou were divided into two groups according to the severity of pneumonia. The levels of serum procalcitonin（ PCT） and C-reactive protein（ CRP） in the patients were detected to compare the value of them in the early diagnosis and treatment of CAP,and the early intervention results of bacterial pneumonia and non-bacterial pneumonia. Results The serum PCT and CRP levels in children with bacterial pneumonia were significantly higher than those in children without bacterial pneumonia,and the differences were statistically significant（ P〈0. 01）; the positive rate of PCT was 85. 62% at hospitalization day 1,but it reduced to 53. 27%,32. 55% respectively at 3 d and 5 d,and the positive rates of PCT and CRP in severe bacterial pneumonia group was significantly higher than mere bacterial pneumonia,with the differences statistically significant（ P〈0. 01）. Conclusion The levels of serum PCT and C-reactive protein can express the therapeutic effect of children with community-acquired pneumonia.