临床常用炎性指标变化与儿童肺炎病原相关性研究

目的检测临床常用炎性指标C反应蛋白、白细胞和中性粒细胞的变化，探讨它们与儿童肺炎之间的关系，从而鉴别病原、帮助诊断、指导治疗。方法收集支气管肺炎患儿550例，采用速率散射比浊法测定C反应蛋白水平，同时进行血常规及相关病原学检查。结果①C反应蛋白升高者192例占35．02％，治疗5d后复查C反应蛋白降至正常者171例占89．09％，治疗前后c反应蛋白均值比较差异有统计学意义（P〈0．001）。②痰或血培养提示细菌生长者40例占7．20％，其中C反应蛋白升高者35例占88．46％；血支原体阳性者14例占2．52％，其中C反应蛋白升高者10例占75．00％，二者c反应蛋白均值比较差异有统计学意义（P〈0．05）。③白细胞或中性粒细胞百分比升高者242例，其中c反应蛋白升高者118例占48．57％；白细胞或中性粒细胞均不升高者308例，其中c反应蛋白升高者75例占24．35％，二者c反应蛋白升高率比较差异有统计学意义（P〈0．01）。结论观察血C反应蛋白、白细胞、中性粒细胞等临床常用炎性指标变化对鉴别儿童肺炎病原、帮助指导诊断与临床治疗具有重要意义。

The Correlation Research of Commonly Used Indicators of Clinical Inflammatory Changes and Pneumonia in Children

Objective To detect the changes of commonly used clinical indicators of inflammation including C-reactive protein,white blood cell and neutrophil,and to explore their relationship with pneumonia in children,in order to identify the pathogen and help to diagnose and guide treatment. Methods Using immunoluminometric assay to determine the C-reactive protein level, meanwhile taking the blood routine test and related pathogen inspection in 550 cases. Results （1）There were 192 cases with elevated C-reactive protein in all children with pneumonia,accounting for 35.02%. After 5 days treatment , ＂the review of C-reactive protein in 171 children fell to normal level,accounting for 89.09%. The means of C-reactive protein before and after treatment was compared,P〈0.001. （2）Forty children were checked out with bacterial growth by sputum or blood culture,accounting for 7.20% and 88.46 percent （35 cases） of these children had elevated C-reactive protein level. Forteen children were checked out with positive blood mycoplasma, accounting for 2.52% and 75.00 percent （10 cases） of these children had elevated C-reactive protein level. The means of C-reactive protein in above two groups was comPared,P〈0.05. （3）In all the patients, 242 had increased leukocytes and elevated percentage of neutrophils,in which the C-reactive protein levels of 118 children elevated, the positive rate was 48. 57%; 308 cases had no increased leukocytes and percentage of neutrophils,in which the C-reactive protein levels of 75 children elevated. The positive rate was 24.35% and the two positive rates was compared,P〈0.01. Conclusion The changes of commonly used clinical indicators of inflammatory like blood C-reactive protein, leukocytes and neutrophils has important significance in identifying the pathogen Of pneumonia in children, helping to guide the diagnose and clinical treatment.