降鈣素原與C反應蛋白聯合檢測在兒童支氣管肺炎及細菌性肺炎中的應用評價

張珍，白威峰

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降鈣素原與C反應蛋白聯合檢測在兒童支氣管肺炎及細菌性肺炎中的應用評價

張珍1，白威峰2

[摘要]目的：評價聯合檢測降鈣素原(PCT)和C反應蛋白(CRP)水平變化在兒童支氣管肺炎及細菌性肺炎患者療效及預后判斷中的臨床意義。方法：2014年2月-2015年2月兒科綜合病區102例支氣管肺炎及細菌性肺炎兒童血清標本，其中支氣管肺炎55例，細菌性肺炎47例，另將35名健康的兒童作為對照組。用化學發光法和乳膠凝集法分別檢測其血清PCT及CRP水平。結果：以PCT>0.5 ng/ml及CRP>10 mg/L作為陽性判斷標準，支氣管肺炎及細菌性肺炎組血清PCT和CRP的陽性率明顯高于對照組(P<0.01)；同時，支氣管肺炎及細菌性肺炎組血清中的PCT和CRP的水平也明顯高于對照組(P<0.01)；再經過有效抗菌藥物治療后，支氣管肺炎及細菌性肺炎組血清中的PCT和CRP的水平明顯降低(P<0.01)。結論：血清PCT及CRP聯合測定能夠對兒童支氣管肺炎和細菌性肺炎的鑒別診斷具有重要的參考價值，而動態監測PCT、CRP的變化更有助于評估疾病的進展和預后。

[關鍵詞]支氣管肺炎；肺炎，細菌性；降鈣素原；C反應蛋白；兒童

Application of combined determination of serum procalcitonin and CRP in children with bronchial pneumonia and bacterial pneumoniaZHANGZhen,BAIWei-feng.(BengbuFirstPeople'sHospital,Anhui233000,China)

【Abstract】Objective：To evaluate the clinical significance of combined determination of serum procalcitonin (PCT) and C reactive protein(CRP) in the curative effect and prognosis in children with bronchial pneumonia and bacterial pneumonia.Methods:From February 2014 to February 2015，a total of 102 blood samples were collected from children who had been diagnosed with bronchial pneumonia and bacterial pneumonia in pediatric department of our hospital.Among them,55 were diagnosed with bronchial pneumonia,47 with bacterial pneumonia.At the same time 35 healthy children were chosen as a control group.Serum PCT and CRP levels were analyzed by using chemiluminescence method and latex agglutination.Results:PCT level exceeding 0.5 ng / ml and CRP level exceeding 10mg/L in serum was judged as positive.The positive rates of PCT and CRP in the bronchial pneumonia and bacterial pneumonia group were significantly higher than those in the control group(P<0.01).Meanwhile, serum PCT and CRP levels for the bronchial pneumonia and bacterial pneumonia group were significantly higher than those of the control group(P<0.01).The changed levels of PCT and CRP in the bronchial pneumonia and bacterial pneumonia group after the effective antibiotic treatment were statistically significant(P<0.01).Conclusion:The combined determination of serum PCT and CRP levels are of important value for differential diagnosis of childhood with bronchial pneumonia and bacterial pneumonia.Dynamically monitoring serum PCT and CRP level will contribute to evaluating progress and prognosis of the disease.

【Key words】Bronchopneumonia；Pneumonia, bacterial; Procalcitonin; C reactive protein; Children

支氣管肺炎(常由細菌或病毒引起，也可由病毒、細菌“混合感染”)和細菌性肺炎是臨床上比較常見的威脅兒童身心健康的下呼吸道感染疾病，若得不到及時治療或處理不當，則會引發較嚴重的并發癥。然而，由于該疾病在臨床上缺乏特異性癥狀和體征，較容易與其他的疾病混淆，在發病早期容易誤診和誤治。降鈣素原(procalcitonin，PCT)在細菌感染的患者血清水平明顯增高，對于細菌引起的感染有著較高的靈敏度和特異性，現已成為重要炎性反應檢測指標[1]；C反應蛋白(c-reactive protein，CRP)是主要的急性期蛋白，在細菌感染機體時其在血漿內濃度明顯升高[2]。本研究通過對在我院確診的支氣管肺炎及細菌性肺炎患兒的血清PCT和CRP進行檢測，以探討二者聯合檢測在臨床上的應用價值。

1資料與方法