超敏C-反应蛋白、白细胞联合检测在儿童呼吸道感染不同中医证型中的临床应用

Clinical Application of Combined Detection of Hypersensitive C-Reactive Protein and White Blood Cell in Children with Upper Respiratory Tract Infection with Different Chinese Medicine Syndromes

目的:探讨超敏C-反应蛋白(hs-CRP)和白细胞(WBC)联合检测在不同中医证型儿童上呼吸道感染中的临床应用。方法:选取上呼吸道感染患儿636例,将儿童呼吸道感染分为风寒束表证、风热犯表证、暑湿袭表证、风躁犯表证、寒热夹杂证5个证型,比较并分析患儿不同中医证型的发生频率;分析不同中医证型与病原体感染的关系以及hs-CRP、WBC水平的差异。结果:在636例患儿中,以风热犯表证发病率最高,占40.72%;次之为风寒束表证、暑湿袭表证、寒热夹杂证,而风躁犯表证发病率最低,占8.18%。所有患儿检出病原体感染共464例,阳性率为72.96%。不同中医证型患儿病毒性感染和细菌感染比例差异显著(P <0.05)。风热犯表证患儿病毒性感染比例明显高于其他证型(P <0.05);寒热夹杂证患儿病毒性感染比例明显低于其他证型(P <0.05);寒热夹杂证患儿细菌性感染比例明显高于其他证型(P <0.05);风热犯表证患儿细菌性感染比例明显低于其他证型(P <0.05)。不同中医证型患儿hs-CRP及WBC水平差异显著(P <0.05)。风热犯表证患儿hs-CRP和WBC水平明显低于其他证型(P <0.05);风寒束表证和寒热夹杂证患儿hs-CRP和WBC水平明显高于风热犯表证、暑湿袭表证和风躁犯表证(P <0.05)。结论:hs-CRP和WBC联合检测对患儿上呼吸道感染的不同中医证型诊断具有一定的辅助作用,可在临床上参考应用。

Objective:To investigate the clinical application of hypersensitive C-reactive protein(hs-CRP) and white blood cell(WBC) in children with upper respiratory tract infection with different Chinese medicine syndromes. Methods: A total of636 cases of children with upper respiratory tract infection were selected, and were differentiated into five syndromes,namely, syndrome of wind-cold fettering the exterior, syndrome of wind-heat invading the exterior, syndrome of summerheat-damp attacking the exterior, syndrome of wind-dryness invading the exterior, and syndrome of intermingled cold-heat. In those children,the frequency of the above Chinese medicine syndromes was compared and analyzed,and the relationship between pathogen infection and levels of hs-CRP as well as WBC was analyzed. Results: Among the 636 children,the incidence of syndrome of wind-heat invading the exterior was the highest(40.72%),followed by syndrome of wind-cold fettering the exterior, syndrome of summerheat-damp attacking the exterior, and syndrome of intermingled cold-heat,and the incidence of syndrome of wind-dryness invading the exterior was the lowest(8.18%). A total of 464 cases of pathogen infection were detected in all children, with a positive rate of 72.96%. The proportion of viral infection and bacterial infection in children with different Chinese medicine syndromes was significantly different(P < 0.05). The proportion of viral infection in children with syndrome of wind-heat invading the exterior was significantly higher than that of other syndromes(P < 0.05), while the proportion of viral infection in children with syndrome of intermingled cold-heat was significantly lower than that of other syndromes(P < 0.05). The proportion of bacterial infection in children with syndrome of intermingled cold-heat was significantly higher than that of other syndromes(P < 0.05), while the proportion of bacterial infection in children with syndrome of wind-heat invading the exterior was significantly lower than that of other syndromes(P<0.05). Levels of hs-CRP and WBC in children with different Chinese medicine syndromes were significantly different(P <0.05). Levels of hs-CRP and WBC in children with syndrome of wind-heat invading the exterior were significantly lower than those of other syndromes(P < 0.05), while the ones in children with syndrome of wind-cold fettering the exterior and syndrome of intermingled cold-heat were significantly higher than those of syndrome of wind-heat invading the exterior,syndrome of summerheat-damp attacking the exterior and syndrome of wind-dryness invading the exterior(P < 0.05).Conclusion:The combined detection of hs-CRP and WBC can play an auxiliary role in the diagnosis of upper respiratory tract infection in children with different Chinese medicine syndromes,and can be used for clinical reference.