hs-CRP、WBC、PCT及T细胞免疫指标在不同感染性肺炎患儿血清中的变化及临床意义  

Changes of hs-CRP,WBC,PCT and T Cell Immune Markers in Serum of Children with Different Infectious Pneumonia and Their Clinical Significances

作　　者：周颖 杨剑敏[1] 黄洁[1] 王宝平[1] 赵琦[1] 张泓[1] ZHOU Ying;YANG Jian-min;HUANG Jie;WANG Bao-ping;ZHAO Qi;ZHANG Hong(Clinical Laboratory,Shanghai Children′s Hospital,Children′s Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200333,China)

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院检验科

出　　处：《标记免疫分析与临床》2019年第10期1701-1705,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的考察不同感染性肺炎患儿血清中超敏C反应蛋白(high-sensitivity CRP,hs-CRP)、白细胞计数(white blood cell count,WBC)、降钙素原(procalcitoin,PCT)和T细胞免疫标志物的变化及临床意义。方法选择2017年6月至2018年6月住院的120例肺炎患儿,其中45例为细菌性肺炎,39例为支原体肺炎,36例为病毒性肺炎,另25例为正常体检儿童作为对照组。测定四组儿童血清hs-CRP、PCT、T细胞免疫指标及全血WBC水平。结果细菌性肺炎和支原体肺炎患儿hs-CRP、WBC和PCT水平显著高于对照组(P<0.05),而患病毒性肺炎儿童hs-CRP、WBC和PCT水平与对照组差异无统计学意义(P>0.05)。细菌性肺炎患儿的hs-CRP、WBC、PCT及联合检测的阳性率显著高于支原体肺炎患儿、病毒性肺炎患儿及对照组儿童(P<0.05)。患有细菌性肺炎患儿、支原体肺炎患儿、病毒性肺炎患儿CD3^+、CD4^+、CD4^+/CD8^+、CD4^+CD25^+Treg与对照组比较,差异均有统计学意义(P<0.05)。结论患有肺炎的儿童体内存在免疫失调,临床上联合检测hs-CRP、WBC、PCT对诊断儿童细菌性肺炎、监测细菌性肺炎患儿预后具有重要的临床价值。Objective To investigate the changes and clinical significances of serum hs-CRP,WBC,PCT and T cell immune indexes in children with pneumonia.Methods 120 children with pneumonia admitted to our hospital from June to May,2018 were enrolled for the study,including 45 cases of bacterial pneumonia,39 cases of mycoplasmal pneumonia,and 36 cases of viral pneumonia.At the same time,25 children with normal physical examination results were selected as the control group.Serum hs-CRP,PCT,T cell immunity and whole blood WBC level were measured in all four groups.Results hs-CRP levels in children with bacterial pneumonia and mycoplasmal pneumonia were significantly higher than healthy controls(P<0.05).There was no significant difference in serum hs-CRP level between the children with viral pneumonia and the control group(P>0.05).WBC levels in the bacterial pneumonia group and mycoplasma pneumonia group were significantly higher than those in the control group(P<0.05),The WBC level of viral pneumonia was not significantly different from the control group(P>0.05).Serum PCT levels in the bacterial pneumonia group and mycoplasma pneumonia group were significantly higher than those in the healthy control group(P<0.05).There was no significant difference for PCT between the viral pneumonia group and the control group(P>0.05).The positive rates of hs-CRP,WBC,PCT and combined detection in the bacterial pneumonia group were significantly higher than those in the mycoplasma pneumonia group,the viral pneumonia group and the healthy control group(P<0.05).Bacterial pneumonia,mycoplasma pneumonia,viral pneumonia CD3^+,CD4^+,CD4^+/CD8^+,CD4^+CD25^+Treg were significantly different from the control group(P<0.05).Conclusion There are immunological disorders in children with pneumonia.In clinical examination,combined detection of hs-CRP,WBC and PCT has an important clinical significance for the diagnosis of bacterial pneumonia in children,as well as the dynamic monitoring of bacterial infection and clinical guidance.

关 键 词：儿童肺炎 HS-CRP WBC PCT T淋巴细胞 

分 类 号：R72[医药卫生—儿科]