肺炎支原体肺炎患儿血清降钙素原和C反应蛋白水平变化的临床意义

The clinical significance of the serum level changes of procalcitonin and C-reactive protein in children with mycoplasma pneumoniae pneumonia

目的:分析肺炎支原体肺炎(MPP)患儿血清降钙素原(PCT)和C反应蛋白(CRP)水平变化及临床意义。方法:收集肺炎患儿47例,根据病情分为MPP组24例和细菌性肺炎(BP)组23例,另收集同时期健康体检儿童20名作为对照组。比较各组受试者血清PCT和CRP水平;并将MPP组患儿按照病程分为急性期和恢复期,比较PCT和CRP水平。结果:MPP组和BP组患儿血清CRP、PCT水平均明显高于对照组(P<0.01),BP组血清CRP、PCT水平均明显高于MPP组(P<0.01)。MPP恢复期患儿的血清CRP、PCT水平均明显低于急性期(P<0.01)。血清CRP水平为18.95 mg/L时,诊断MPP的敏感度为82.6%,特异度为66.7%,受试者工作特征曲线下面积(AUC)为0.743;血清PCT水平为0.36 ng/m L时,诊断MPP的敏感度为69.6%,特异度为83.3%,AUC为0.752;二者联合诊断时,诊断MPP的敏感度为87.0%,特异度为87.5%,AUC为0.881。结论:MPP患儿血清PCT、CRP水平均明显升高,二者可作为MPP病情评估与早期诊断的重要指标。

Objective： To analyze the serum level changes of procalcitonin（PCT） and C-reactive protein（CRP） in children with Mycoplasma pneumoniae pneumonia（MPP）,and its clinical significance.Methods： Forty-seven children with pneumonia were divided into the MPP group（ n =24） and bacterial pneumonia（BP） group（ n =23） according to the disease,and 20 physical examination healthy children were set as the control group during the same period.The serum levels of PCT and CRP among three groups were compared.The MPP group was subdivided into the acute phase and recovery phase according to the course of disease,and the levels of PCT and CRP between two phases were compared.Results： The serum levels of CRP and PCT in MPP group and BP group were significantly higher than those in control group（ P 〈0.01）,and the serum levels of CRP and PCT in MPP group were significantly lower than those in BP group（ P 〈0.01）.Among the MMP group,the serum levels of CRP and PCT in children in recovery phase were significantly lower than those in children in acute phase（ P 〈0.01）.The serum level of CRP in MPP group was set as 18.95 mg/L in recovery phase,the sensitivity and specificity of CRP in diagnosing MPP were 82.6% and 66.7%,respectively,and the area under ROC curve（AUC） was 0.743.The serum level of PCT was set as 0.36 ng/mL,the sensitivity and specificity of PCT in diagnosing MPP were 69.6% and 83.3%%,respectively,and the AUC was 0.752.The sensitivity and specificity of CRP combined with PCT in diagnosing MPP were 87.0% and 87.5%,respectively,and the AUC was 0.881.Conclusions： The serum levels of PCT and CRP in children with MPP significantly increase,which can be used as an important index in evaluating the illness and early diagnosis of MPP.