PCT、CRP及WBC在儿童支气管肺炎病原诊断的临床意义

陈敏　严琴琴

摘要：目的  探討降钙素原（PCT）、C反应蛋白（CRP）及白细胞（WBC）计数在儿童支气管肺炎病原诊断中的临床意义。方法  选取2018年6月～2018年12月在西安市儿童医院呼吸科病房经胸片或胸部CT确诊的社区获得性肺炎204例患者作为研究对象，根据实验室检查诊断分为细菌组（90例）、支原体组（69例）和病毒组（45例），另选取同一时期健康儿童50名作为对照组，比较4组降钙素原（PCT）、C反应蛋白（CRP）及白细胞（WBC）计数水平及阳性检出率。结果  细菌组儿童PCT、CRP、WBC检测结果均高于支原体组、病毒组及对照组，且支原体组PCT检测结果高于病毒组及对照组，差异有统计学意义（P<0.05）;支原体组、病毒组与对照组CRP、WBC检测结果比较，差异无统计学意义（P>0.05）;细菌组PCT、CRP及WBC阳性率高于支原体组、病毒组及对照组，且支原体组仅PCT阳性率与病毒组和对照组比较，差异有统计学意义，而CRP和WBC 的阳性率与病毒组和对照组比较无统计学意义（P>0.05）。结论  PCT能较好的鉴别肺炎患儿的病因，并且PCT检测对儿童肺炎病原菌的诊断优于CRP和WBC计数。

关键词：降钙素原;C反应蛋白;白细胞计数;支气管肺炎

中图分类号：R725.6                                文献标识码：A                                 DOI：10.3969/j.issn.1006-1959.2020.14.028

文章编号：1006-1959（2020）14-0098-03

Clinical Significance of PCT，CRP and WBC in the Diagnosis of Bronchopneumonia in Children

CHEN Min，YAN Qin-qin

（Department of Pediatrics，School of Clinical Medicine，Xi'an Medical College，Xi'an 710021，Shaanxi，China）

Abstract：Objective  To explore the clinical significance of procalcitonin （PCT）， C-reactive protein （CRP） and white blood cell （WBC） counts in the diagnosis of bronchopneumonia in children.Methods  From June 2018 to December 2018， 204 patients with community-acquired pneumonia diagnosed by chest radiography or chest CT in the respiratory ward of Xi'an Children's Hospital were selected as the research objects， and were divided into the bacterial group （90 cases） according to the laboratory diagnosis ）， mycoplasma group （69 cases） and virus group （45 cases）， and 50 healthy children in the same period were selected as a control group， comparing 4 groups of procalcitonin （PCT）， C-reactive protein （CRP） and white blood cells （WBC） Count level and positive detection rate.Results  The PCT， CRP and WBC test results of children in the bacterial group were higher than those of the mycoplasma group， virus group and control group， and the PCT test results of the mycoplasma group were higher than that of the virus group and control group， the difference was statistically significant （P<0.05）; There was no significant difference in the CRP and WBC test results between the virus group and the control group （P>0.05）; the PCT， CRP and WBC positive rates in the bacterial group were higher than those in the mycoplasma group， virus group and control group， and only the PCT positive rate in the mycoplasma group compared with the virus group and the control group， the difference was statistically significant， while the positive rates of CRP and WBC were not statistically significant compared with the virus group and the control group （P>0.05）.Conclusion  PCT can better identify the etiology of children with pneumonia， and PCT detection is better than CRP and WBC counts in the diagnosis of pneumonia pathogens in children.

Key words：Procalcitonin;C-reactive protein;White blood cell count;Bronchopneumonia

肺炎（pneumonia）是儿科常见病、多发病，其中支气管肺炎是儿童最常见的类型，由多种病原微生物引起，但临床表现相似，病原学检测作为诊断病原的金标准，但病原检测时间相对较长，而儿童病情变化快，治疗时机的早晚与预后密切相关，故病原学检测不利于早期鉴别诊断，临床上医生一般凭经验进行抗感染治疗，但会导致治疗效果不佳或抗生素的滥用。随着医学的发展及检测技术的进步、创新，血清学指标检测方便又快速，C反应蛋白（CRP）、白细胞（WBC）计数测定可作为支气管肺炎病原诊断的初步筛查手段，近年来，降钙素原（PCT）在感染性疾病中的临床价值逐渐凸显出来。本研……