支原体肺炎患儿C反应蛋白、血清淀粉样蛋白A和白细胞计数水平的变化及意义

廖耀华 王沛 肖丹夏

[摘要]目的 探讨支原体肺炎（MP）患儿C反应蛋白（CRP）、淀粉样蛋白A（SAA）和白细胞计数（WBC）水平的变化及意义。方法 选取2016年6月～2019年6月在我院接受治疗的200例MP患儿进行回顾性分析。200例患儿中，轻症患儿165例，重症患儿35例。另选取同时期在我院体检的50例健康儿童作为对照组。测定急性期和治疗后恢复期两组及对照组血清中CRP、SAA、WBC含量的变化情况。结果 急性期，重症组的CRP、SAA含量高于轻症组，差异有统计学意义（P<0.05）;急性期，重症组的WBC含量与轻症组比较，差异无统计学意义（P>0.05）。治疗后，重症组和轻症组恢复期的CRP、SAA含量低于急性期，差异均有统计学意义（P<0.05）;重症组恢复期的WBC含量与急性期比较，差异无统计学意义（P>0.05）。重症组和轻症组恢复期CRP、SAA、WBC含量高于对照组，差异均有统计学意义（P<0.05）。结论 CRP、SAA在判断MP患儿病情严重程度时有良好的应用价值，WBC仅能作为存在炎症性反应参考依据，无法判断病情严重程度。

[关键词]小儿支原体肺炎;C反应蛋白;血清淀粉样蛋白A;白细胞计数;病情程度

[中图分类号] R725.6          [文献标识码] A          [文章编号] 1674-4721（2020）6（b）-0122-03

[Abstract] Objective To investigate the changes and significance of C-reactive protein （CRP）， serum amyloid A （SAA） and white blood cell count （WBC） in children with Mycoplasma pneumonia （MP）. Methods A retrospective analysis was performed on 200 children with MP who were treated in our hospital from June 2016 to June 2019. Of the 200 children， 165 had mild MP and 35 had severe MP. Another 50 healthy children who underwent physical examination in our hospital at the same time were selected as the control group. The changes of serum CRP， SAA， WBC content in the two groups of children in the acute phase and the recovery period after treatment and the healthy children in the control group were measured. Results In the acute period， the CRP and SAA contents of children in the severe group were higher than those in the mild group， and the differences were statistically significant （P<0.05）; compared with the mild group， the WBC content in the children in the severe group was not different statistical significance （P>0.05）. After treatment， the CRP and SAA contents in the recovery group of the severe group and the mild group were lower than those in the acute phase， and the differences were statistically significant （P<0.05）; comparison of WBC content in recovery period and acute period in severe group， the difference was not statistically significant （P>0.05）. Conclusion CRP and SAA have good application value in judging the severity of MP children. WBC can only be used as a reference for the existence of inflammatory reactions， and it cannot judge the severity of the disease.

[Key words] Mycoplasmal pneumonia in children; C-reactive protein; Serum amyloid A; white blood cell; Severity of illness

支原體肺炎（Mycoplasma pneumonia，MP）是儿科门诊常见的一类疾病，秋冬季节更高发[1-2]，患儿临床表现为发热、咳嗽、呼吸急促等表现，严重时出现剧咳胸痛或呕吐腹泻症状[3-5]，患儿病情较轻者恢复需2～3周，病情严重时需要4～5周[6]。近年来已逐渐出现MP菌株耐药现象，不利于MP患儿的康复。诊断MP最可靠的方法是MP进行分离培养，然后检查MP血清学抗体[7]，此方法虽准确度高但耗时较久，对儿童来说由于免疫能力较低，易出现假阴性抗体影响诊断，寻找到与MP有关的生物学指标对早期辅助诊断MP病情有重要意义。……