白细胞计数及降钙素原、C反应蛋白联合检测在儿童社区获得性肺炎诊断中的应用

doi:10.3969/j.issn.1674-3865.2018.04.015

中国中西医结合儿科学 ›› 2018, Vol. 10 ›› Issue (4): 323-326.doi: 10.3969/j.issn.1674-3865.2018.04.015

白细胞计数及降钙素原、C反应蛋白联合检测在儿童社区获得性肺炎诊断中的应用

冷秀芝

466200 河南项城，项城市第一人民医院儿科

出版日期:2018-08-25 发布日期:2018-12-03
作者简介:冷秀芝（1971-），女，副主任医师。研究方向：小儿常见疾病的治疗，E-mail：3340896059@qq.com

Application of combined detection of white blood cell count, procalcitonin and C-reactive protein in the diagnosis of children with community-acquired pneumonia

LENG Xiuzhi

Department of Pediatrics, the First People's Hospital of Xiangcheng City，Xiangcheng 466200，China

Online:2018-08-25 Published:2018-12-03

摘要/Abstract

摘要：
目的
观察外周血白细胞计数及血浆降钙素原、C反应蛋白三项联检在儿童社区获得性肺炎诊断中的应用。
方法
选取2016年8月至2017年7月本院儿科收治社区获得性肺炎患儿106例为研究对象，按感染类型分为细菌感染组57例和非细菌感染组49例。细菌感染组又分为革兰阳性菌组26例，革兰阴性菌组31例；重症感染组19例和非重症感染组38例。同期选取本院健康体检儿童60例为对照组。比较各组白细胞、降钙素原、C反应蛋白水平。
结果
细菌感染组外周血白细胞计数及血浆降钙素原水平显著高于非细菌感染组和对照组，差异有统计学意义（P<0.05）；细菌感染组和非细菌感染组血浆C反应蛋白水平显著高于对照组，差异有统计学意义（P<0.05）。细菌感染组重症感染患儿血浆降钙素原、C反应蛋白水平显著高于非重症感染患儿，差异有统计学意义（P<0.05）。革兰阴性菌组患儿血浆降钙素原水平高于革兰阳性菌组，差异有统计学意义（P<0.05），而外周血白细胞计数及血浆C反应蛋白水平两组比较差异无统计学意义（P>0.05）。细菌感染组患儿给予抗菌药物治疗后，外周血白细胞计数及血浆降钙素原、C反应蛋白水平呈现逐渐下降趋势，至出院时，患儿上述3项指标均恢复到正常人群水平。
结论
外周血白细胞计数及血浆降钙素原、C反应蛋白三项联检可对患儿社区获得性肺炎细菌性和非细菌性感染做出初步诊断，且血浆降钙素原和C反应蛋白水平高低可作为评估病情严重程度、指导临床选择抗菌药物及治疗效果判断的重要依据。

关键词: 社区获得性肺炎, 降钙素原, 白细胞计数, C反应蛋白, 儿童

Abstract:
Objective:
To observe the application of combined detection of white blood cell count, procalcitonin and C-reactive protein in the diagnosis of children with community-acquired pneumonia.
Methods:
A total of 106 children with community-acquired pneumonia treated in our hospital from August 2016 to July 2017 were enrolled as study subjects. According to infection type, the patients were divided into bacteria group(57 cases) and non-bacteria group(49 cases). Bacteria group were divided into Gram-positive bacteria group(26 cases) and Gram-negative bacteria group(31 cases); there were 19 cases in severe infection group and 38 cases in non-severe group. Sixty healthy children in the same period were included as the control group. The WBC, procalcitonin and C-reactive protein levels of the two groups were compared.
Results:
The level of white blood cell count and procalcitonin level in bacteria group were significantly higher than those in non-bacteria group and control group(P＜0.05); the level of C-reactive protein in bacteria group and non-bacteria group were significantly higher than that in control group(P＜0.05) . The level of procalcitonin and C-reactive protein in severe infection group were significantly higher than that in non-severe group(P＜0.05). The level of procalcitonin in Gram-negative bacteria group was significantly higher than that in Gram-positive bacteria group(P＜0.05), but the level of white blood cell count and C-reactive protein was not statistically different between the two groups. After treatment, the level of white blood cell, procalcitonin and C-reactive protein in bacteria group gradually decreased, which returned to normal level before hospital discharge.
Conclusion:
The combination detection of peripheral white blood cell, procalcitonin and C-reactive protein can help to make preliminary diagnosis of bacteria and nonbacteria infection in children with community-acquired pneumonia. The level of procalcitonin and C-reactive protein can be used to assess the disease severity, guide the clinical antibiotic treatment and evaluate the treatment results.

Key words: Community-acquired pneumonia, Procalcitonin, White blood cell count, C-reactive protein, Child

冷秀芝. 白细胞计数及降钙素原、C反应蛋白联合检测在儿童社区获得性肺炎诊断中的应用[J]. 中国中西医结合儿科学, 2018, 10(4): 323-326.

LENG Xiuzhi. Application of combined detection of white blood cell count, procalcitonin and C-reactive protein in the diagnosis of children with community-acquired pneumonia[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2018, 10(4): 323-326.

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白细胞计数及降钙素原、C反应蛋白联合检测在儿童社区获得性肺炎诊断中的应用

Application of combined detection of white blood cell count, procalcitonin and C-reactive protein in the diagnosis of children with community-acquired pneumonia

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