降钙素原、C-反应蛋白与白细胞在儿童重度肺炎的应用  

Detection of serum procalcitonin,C-reactive protein and white blood cell for severe pneumonia in children

作　　者：佟威威[1] 佟广辉[1] 秦晓松[1] 卢丽萍[1] 刘勇[1] 

机构地区：[1]中国医科大学附属盛京医院检验科,沈阳110004

出　　处：《中国小儿急救医学》2015年第6期414-417,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的：探讨血清降钙素原（PCT）、C-反应蛋白（CRP）和白细胞（wBC）在儿童重度肺炎诊断与治疗中的评价作用。方法选取2014年3月至12月入院治疗的儿童肺炎患者189例（包括重度肺炎患儿51例）和30例健康儿童（健康对照组）,对其进行 PCT、CRP 和 wBC 测定。结果重度肺炎组、普通肺炎组治疗前和健康对照组儿童的 PCT 分别为1.12（0.44～3.07）ng /ml、0.14（0.09～0.26）ng /ml 和0.03（0.01～0.06）ng /ml,三组之间两两比较差异均有统计学意义（P 均﹤0.05）；重度肺炎组、普通肺炎组治疗前和健康对照组儿童的 CRP 分别为82.2（25.9～120.3）mg /L、10.8（5.3～23.9）mg /L 和3.2（2.1～6.9）mg /L,三组之间两两比较差异均有统计学意义（P 均﹤0.05）；重度肺炎组、普通肺炎组治疗前和健康对照组儿童的 wBC 分别为10.1（9.1～14.1）×109/L、8.8（6.8～11.7）×109/L 和6.2（4.8～7.9）×109/L,重度肺炎组与普通肺炎组之间及普通肺炎组与健康对照组之间比较差异无统计学意义（P 均﹥0.05）。重度肺炎组患儿经过1周抗炎治疗后,血清 PCT、CRP、wBC 分别为0.15（0.09～0.24）ng /ml、9.9（3.6～19.0）mg /L、8.5（6.3～9.8）×109/L,与治疗前相比,PCT、CRP 明显下降（t ＝2.396、5.805,P ＝0.021、0.000）,而 wBC 无明显变化（t ＝1.312,P ＝0.205）。31例重度肺炎组患儿经抗炎治疗两日后血清 PCT 就下降至治疗前的44%,以后每两日平稳下降至基础值的近10%。189例普通肺炎和重度肺炎患儿血清 PCT 与 CRP 的浓度存在相关性（R2＝0.5504,P ﹤0.05）。结论 PCT 和 CRP 联合检测对儿童重度肺炎的鉴别诊断、治疗及预后评估均有重要的指导作用。Objective To explore the clinical effect of detection of serum procalcitonin （PCT）, C-reactive protein （CRP）and white blood cell （wBC）on diagnosis and treatment of severe pneumonia in children.Methods A total of 189 cases of pediatric patients with pneumonia including 51 severe pneumonia cases （severe pneumonia group）and 138 common pneumonia cases （common pneumonia group）treated from Mar 2014 to Dec 2014 and 30 healthy cases （control group）were enrolled,and the level of PCT,CRP and wBC of all cases were detected.Results The levels of PCT before treatment in severe pneumonia group,common pneumonia group,and control group were 1.12（0.44 ～3.07）ng /ml,0.14 （0.09 ～0.26） ng /ml and 0.03（0.01 ～0.06）ng /ml respectively,and there were significant differences among three groups （P ﹤0.05,respectively）.The levels of CRP before treatment in severe pneumonia group,common pneumonia group,and control group were 82.2（25.9 ～120.3 ）mg /L,10.8 （5.3 ～23.9）mg /L and 3.2 （2.1 ～6.9） mg /L respectively,and there were significant differences among three groups （P ﹤0.05,respectively）.The counts of wBC before treatment in severe pneumonia group,common pneumonia group,and control group were 10.1 （9.1 ～14.1 ）×10^9 /L,8.8（6.8 ～1 1.7）×10^9 /L and 6.2（4.8 ～7.9）×10^9 /L respectively,and there was significant difference only between severe pneumonia group and control group （P ﹤0.05 ）.The level of PCT and CRP significantly decreased in severe pneumonia group after one week of treatment[PCT：0.15（0.09 ～0.24）ng /ml,CRP：9.9（3.6 ～19.0）mg /L]（P ﹤0.05）,but there was no significant differ-ence of wBC counts in severe pneumonia group between after and before treatment[8.5（6.3 ～9.8）×10^9 /L vs.10.1 （9.1 ～14.1 ）×10^9 /L]（t =1.312,P =0.205 ）.After two days of anti-inflammatory treatment in severe pneumonia group,serum PCT dropped to 44% of the level before treatment,and smoothly dropped to nearly 10% of the basic value ever

关 键 词：降钙素原 C-反应蛋白 白细胞 重度肺炎 

分 类 号：R725.6[医药卫生—儿科] R446.1[医药卫生—临床医学]