PCT、CRP及WBC在儿童支气管肺炎病原诊断的临床意义

Clinical Significance of PCT,CRP and WBC in the Diagnosis of Bronchopneumonia in Children

目的探讨降钙素原(PCT)、C反应蛋白(CRP)及白细胞(WBC)计数在儿童支气管肺炎病原诊断中的临床意义。方法选取2018年6月~2018年12月在西安市儿童医院呼吸科病房经胸片或胸部CT确诊的社区获得性肺炎204例患者作为研究对象,根据实验室检查诊断分为细菌组(90例)、支原体组(69例)和病毒组(45例),另选取同一时期健康儿童50名作为对照组,比较4组降钙素原(PCT)、C反应蛋白(CRP)及白细胞(WBC)计数水平及阳性检出率。结果细菌组儿童PCT、CRP、WBC检测结果均高于支原体组、病毒组及对照组,且支原体组PCT检测结果高于病毒组及对照组,差异有统计学意义(P<0.05);支原体组、病毒组与对照组CRP、WBC检测结果比较,差异无统计学意义(P>0.05);细菌组PCT、CRP及WBC阳性率高于支原体组、病毒组及对照组,且支原体组仅PCT阳性率与病毒组和对照组比较,差异有统计学意义,而CRP和WBC的阳性率与病毒组和对照组比较无统计学意义(P>0.05)。结论PCT能较好的鉴别肺炎患儿的病因,并且PCT检测对儿童肺炎病原菌的诊断优于CRP和WBC计数。

Objective To explore the clinical significance of procalcitonin(PCT),C-reactive protein(CRP)and white blood cell(WBC)counts in the diagnosis of bronchopneumonia in children.Methods From June 2018 to December 2018,204 patients with community-acquired pneumonia diagnosed by chest radiography or chest CT in the respiratory ward of Xi'an Children's Hospital were selected as the research objects,and were divided into the bacterial group(90 cases)according to the laboratory diagnosis),mycoplasma group(69 cases)and virus group(45 cases),and 50 healthy children in the same period were selected as a control group,comparing 4 groups of procalcitonin(PCT),C-reactive protein(CRP)and white blood cells(WBC)Count level and positive detection rate.Results The PCT,CRP and WBC test results of children in the bacterial group were higher than those of the mycoplasma group,virus group and control group,and the PCT test results of the mycoplasma group were higher than that of the virus group and control group,the difference was statistically significant(P<0.05);There was no significant difference in the CRP and WBC test results between the virus group and the control group(P>0.05);the PCT,CRP and WBC positive rates in the bacterial group were higher than those in the mycoplasma group,virus group and control group,and only the PCT positive rate in the mycoplasma group compared with the virus group and the control group,the difference was statistically significant,while the positive rates of CRP and WBC were not statistically significant compared with the virus group and the control group(P>0.05).Conclusion PCT can better identify the etiology of children with pneumonia,and PCT detection is better than CRP and WBC counts in the diagnosis of pneumonia pathogens in children.