不同类型肺炎患儿血清hs-CRP和PCT及部分外周血T细胞免疫指标的变化

The Diagnosis Value of the Serum hs-CRP, PCT and T-lymphocytes Immune Index in Children with Pneumonia

目的:探讨不同类型肺炎患儿血清超敏C反应蛋白(hs-CRP)、降钙素原(PCT)及部分外周血T细胞免疫指标的变化。方法:120例肺炎患儿根据病原体检测结果分成细菌组(细菌性肺炎,n=67)、病毒组(病毒性肺炎,n=33)及支原体组(支原体肺炎,n=20),选取100例同期健康体检的健康儿童作为对照组;3个肺炎组患儿于入院次日、对照组儿童于体检时检测血清hs-CRP、PCT水平并计算PCT阳性率,同时检测外周血T淋巴细胞CD3+、CD4+、CD4+CD25+、CD8+及CD4+/CD8+水平。结果:各组儿童血清hs-CRP水平比较,细菌组>支原体组>病毒组和对照组,差异有统计学意义(P<0.05);各组儿童血清PCT水平比较,细菌组>支原体组>病毒组>对照组,差异有统计学意义(P<0.05);各组儿童血清PCT阳性率比较,细菌组>支原体组和病毒组>对照组,差异有统计学意义(P<0.05);3组肺炎患儿外周血CD3+、CD4+、CD4+/CD8+水平均低于对照组(P<0.05),CD4+CD25+水平均显著高于对照组(P<0.05),除病毒组外,细菌组与支原体组的CD8+水平均显著高于对照组,差异有统计学意义(P<0.05)。结论:不同类型肺炎患儿的机体内免疫功能均受到影响,血清hs-CRP及PCT水平可以辅助鉴别诊断肺炎的感染类型。

Objective:To analyze the diagnosis value of the detection of the serum high sensitivity C reactive protein(hs-CRP),procalcitonin(PCT),T-lymphocytes immune index in the children with pneumonia.Methods:120 children with pneumonia received treatment at our hospital from March,2018 to November,2018 and 100 healthy children severd as the pneumonia group and control group respectively.The pneumonia group were divided into three groups according to the pathogen detection results——the bacterial pneumonia group(BP group,67 cases),the virus pneumonia group(VP group,33 cases)and the eaton agent pneumonia group(EAP group,20 cases).The general information,the levels of hs-CRP,PCT and T cells immune index in the 4 groups were compared.Results:The general information in the 4 groups had no statistical difference(P>0.05).The hs-CRP,PCT levels and the PCT positive rate in BP group were obviously higher than those in VP group group,the eaton agent pneumonia group and the control group(P<0.05).The hs-CRP level in EAP group was obviously higher than those in the control group and VP group,the PCT level and positive rate in VP group group,EAP group were obviously higher than those in the control group,and the PCT level in VP group was obviously lower than that in EAP group(P<0.05).The levels of CD3+,CD4+,CD4+/CD8+in BP group,VP group and EAP group were obviously lower than those in the control group,and the CD4+CD25+level in BP group,VP group and EAP group were obviously higher than that in the control group(P<0.05),the CD8+level in BP group,EAP group were obviously higher than that in the control group(P<0.05).Conclusion:Children with pneumonia have cellular immune dysfunction.The detection of the serum hs-CRP,PCT could be used to identify and diagnose different types of children's pneumonia index.