全血CRP和白细胞检测在儿童肺炎早期诊断的应用价值

The value of blood C reactive protein and white blood cell count as early diagnosis tools for children pneumonia

目的探讨血常规中白细胞、全血C反应蛋白(CRP)的改变在儿童肺炎患者早期诊断中联合检测的必要性.方法选取笔者所在医院儿童住院患者中儿童肺炎患者210例,分别用XS800i测定白细胞,用免疫层析法检测CRP含量,进行分组分析.观察血常规中白细胞、全血CRP在判断儿童肺炎感染因素中的作用.结果所有实验数据按儿童肺炎类型分为细菌性肺炎组和非细菌性肺炎组,结果显示与非细菌性肺炎患者的结果相比,细菌性肺炎患者的WBC值、中性细胞比例、全血CRP值均明显高于非细菌组的值(P值均<0.001);全血CRP灵敏度最高,约登指数、曲线下面积(AUC)最高为全血CRP+WBC.结论白细胞和全血CRP联合检测对儿童肺炎的类型判断,联合敏感率并没有明显提高,但联合特异性略有提高,所以选择联合的时机要把握好以达到准确灵敏又节约成本的目的.

Objective To evaluate the clinical significance of combined determination of serum white blood cell count(WBC)and C reactive protein(CRP)in children with early pneumonia.Methods From January 2015 to January 2016,a total of 210 blood samples were collected from children who had been diagnosed with pneumonia in pediatric department of our hospital.At the same time children’s WBC,Proportion of neutral cells and CRP levels were analyzed.Results In bacterial pneumonia,WBC,Proportion of neutral cells and CRP levels were obvious in a higher level(P < 0.01).The most sensitive is CRP.The best AUC and YI are WBC and WBC+CRP.The most sensitive is CRP.The best AUC and YI are WBC and WBC+CRP.Conclusion When WBC and CRP both used for diagnosing the reason of pneumonia,the sensitivity is worse,the specificity is better.So the timing is important when you choose CRP and save your money.