C反应蛋白测定在儿童肺炎中的应用价值

摘要

目的 探讨C反应蛋白在小儿细菌性肺炎、支原体肺炎和病毒性肺炎诊断中的应用价值.方法 入住本院的200例小儿肺炎患者作为观察组,采用免疫透射比浊法测定儿童肺炎急性期、恢复期和治愈后血清C反应蛋白的值,180例同期体检的健康儿童作为对照组,同时做细菌培养、支原体抗体检测和病毒血清抗体检测.结果 急性期时,112例细菌性肺炎肺炎患者中(A组)C反应蛋白阳性率为96.4%;58例支原体肺炎患儿中(B组)阳性率为77.5%;30例病毒性肺炎患儿(C组)中阳性率为13.3%;180例健康对照组(D组)阳性率为8.3%.A组、B组的阳性率差异具有统计学意义(P<0.05),均高于对照组(P＜0.05);而C组与对照组比较差异无统计学意义(P>0.05).恢复期A、B组患儿的C反应蛋白值明显降低(P<0.05),但仍高于对照组;治愈后A、B组患儿C反应蛋白的值与对照组比较差异无统计学意义(P>0.05).结论 血清C反应蛋白值可作为儿童肺炎的辅助鉴别指标,其升高程度的高低对细菌性肺炎与支原体肺炎的鉴别有临床意义,同时动态检测血清C反应蛋白水平对于判定疗效及确定疗程有着一定的临床意义.%Objective To investigate the diagnosis value of C-reactive protein in children with bacterial pneumonia, mycoplasma pneumonia and viral pneumonia. Methods CRP levels were measured in acute phase, recovery phase and cured phase in children with pneumonia of observation group including 200 in hospitalized pediatric patients, at the same time the CRP levels were measured in 180 healthy children which was as the control group. The bacterial culture, mycoplasma and virus antibodies in serum antibodies were measured. Results In the acute period,C-reactive protein positive rate in 112 cases with bacterial pneumonia (group A) was 96.4％; 58 cases with mycoplasma pneumonia (group B) was 77.5％; 30 cases with viral pneumonia (group C) was 13.3％; 180 healthy control group (group D) was 8.3％. Compared with that of control group, positive rates of group A, B were higher (P＜0.05), and there was statistically significant differences between group A and B (P＜0.05); while the C group and control group showed no significant difference. In recovery period, C-reactive protein of group A, B was significantly lower (P＜0.05), but still higher than the control group. In cured period, C reactive protein of the group A and group B had no difference with the control group. Conclusion Serum C-reactive protein values can be used as indicators of childhood pneumonia of differentiation, the level of its higher degree of bacterial pneumonia and mycoplasma pneumonia has clinical significance of identifying. At the same time, dynamic detection of serum C-reactive protein level has a certain course of treatment efficacy and guiding significance.