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【论著】不同致病原所致小儿重症肺炎血清降钙素原的测定及C反应,蛋白白细胞计数的改变及其临床意义


  09-06-12  


摘要目的探讨不同病原体致重症肺炎患儿血清降钙素原(PCT)含量及C反应蛋白(CRP)水平,白细胞计数(WBC)改变及其临床意义。方法选取重症肺炎的住院患儿86例。于急性期、恢复期取静脉血,采用发光免疫分析法定量测定PCT,免疫透射比浊法测定CRP。 结果急性期细菌感染者PCT值>0.5 ng/mL明显高于正常、病毒与支原体感染者PCT值<0.5 ng/mL仅轻度升高。细菌性与病毒性、支原体肺炎比较,PCT值差异具有统计学意义(P<0.01),病毒性与支原体肺炎比较,PCT值差异无统计学意义(P>0.05)。病毒性肺炎CRP值与细菌性、支原体肺炎比较,差异具有统计学意义(P<0.01),但细菌性与支原体肺炎CRP值比较差异无统计学意义(P>0.05)。病毒性肺炎WBC 计数与细菌性肺炎比较差异有统计学意义(P<0.01),但病毒性与支原体肺炎比较差异无统计学意义(P>0.05)。结论临床联合检测血清PCT值和CRP值,WBC 计数,细胞形态等有助于细菌性肺炎的早期诊断、指导治疗。但PCT值不能取代支原体抗体的检测,判断支原体或病毒感染,仍需结合年龄、症状、体征、胸片特点及病原学检测等综合判断。
关键词肺炎降钙素原C反应蛋白
The clinical significance of serum PCT level, CRP and WBC in infants with severe Pneumonia caused by different morbigenous pathogens
LIU ZhijingZHANG YajingWANG XinZHOU Fang
ABSTRACTObjectiveInvestigate the differences and the clinical significance of serum PCT level, CRP level and WBC count in infants with severe Pneumonia caused by Different morbigenous pathogens. Methodseightysix children diagnosed as pneumonia patients from 2007.1 to 2007.8 in our hospital were enrolled. The venous blood samples were obtained at acute period and recovery stage. Use immunoluminometric assay to measure the PCT level and use immunoturbidimetry to measure the CRP level. ResultsThe PCT level of patients with sever Pneumonia at acute stage is higher than normal children, >0.5 ng/mL, and it has slight increase in patients with Viral Pneumonia and Mycoplasmal Pneumonia,<0.5 ng/mL; Compared with Mycoplasmal Pneumonia, the PCT levels have some significant differences between children with Bacterial Pneumonia and Viral Pneumonia (P<0.01),but no significant difference between the Viral one and the Mycoplasmal one(P>0.05); The CPR level has marketable difference in Bacterial Pneumonia when contrasted to Viral Pneumonia and Mycoplasmal Pneumonia and no marketable difference between them(P>0.05). The WBC count of Viral Pneumonia has significant difference compared with that of Bacterial Pneumonia(P<0.01), but when it compared with it in Mycoplasmal Pneumonia, there is no significant difference. ConclusionIn clinical examination, it will be helpful to diagnosis the Bacterial Pneumonia at early stage and it can also direct the therapy according to the serum PCT and CRP, WBC and the form of the cell. But, the detecting of PCT cannot substitute the examination of Mycoplasmal antibody, and comprehensive judgment of the Mycoplasmal infect or the viral infect is considered with the characteristics of age, clinical symptom, signs of lungs, chest film and examination of aetiology etc.
KEY WORDSPneumoniaProcalcitoninCneactveprotein

作者单位内蒙古医学院第三附属医院儿科


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