细菌性肺炎患儿血清CRP-ESR-WBC变化及临床意义.docVIP

细菌性肺炎患儿血清CRP\ESR\WBC变化及临床意义[摘要] 目的:探讨细菌性肺炎患儿血清C反应蛋白(CRP)、血沉(ESR)及白细胞计数(WBC)的变化及临床意义。方法:118例细菌性肺炎患儿分别进行早期及恢复期血清CRP、ESR、WBC水平测定。结果:118例患儿中,93.2%的患儿CRP升高,63.6%的患儿WBC升高,52.5%的患儿ESR升高。恢复期CRP、WBC下降,CRP下降幅度最大。结论:血清CRP及WBC检测有助于细菌性肺炎的诊断,检测CRP有助于细菌性肺炎的疗效评价。 [关键词] 细菌性肺炎;C反应蛋白;白细胞;红细胞沉降率 [中图分类号] R563.1 [文献标识码]B[文章编号]1673-7210(2010)03(c)-027-02 Change and clinical significance of serum CRP, ESR and WBC in children with bacterial pneumonia LU Yanzhen, LU Bo, ZHANG Mingzhen, XUAN Ruihua (Departement of Pediatrics, the First People’s Hospital of Zhaoqing, Zhaoqing 526020, China) [Abstract] Objective: To study the change and clinical significance of serum C reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leucocyte (WBC) in children with bacterial pneumonia. Methods: The levels of serum CRP, ESR and WBC of 118 cases of children with bacterial pneumonia were determined during the early stage and the recovery period. Results: In the 118 cases of children, 93.2% showed increased CRP, 63.6% showed increased WBC, 52.5% showed increased ESR. CRP and WBC came down in recovery period, the decrease of CRP was maximal. Conclusion: Detecting serum CRP and WBC is helpful to diagnose bacterial pneumonia, detecting CRP is helpful to evaluate the efficacy of bacterial pneumonia. [Key words] Bacterial pneumonia; C reactive protein; Leucocyte; Erythrocyte sedimentation rate 肺炎是儿科常见病,由于采集痰标本困难及实验室条件的制约,确定小儿肺炎的病原体相对困难,也制约了细菌性肺炎的早期诊断及抗生素的合理使用。本研究检测118例细菌性肺炎患儿的血清C反应蛋白(CRP)、血沉(ESR)及白细胞计数(WBC),以了解其对小儿细菌性肺炎的诊断及疗效评价的作用。现将结果报道如下: 1对象与方法 1.1研究对象 2007年3月～2009年3月在我科住院的细菌性肺炎患儿共118例,其中,男65例,女53例;年龄3个月～13岁,平均5.3岁;病程2～5 d,118例患儿均符合细菌性肺炎诊断标准[1]:临床表现有咳嗽、咳痰,发热≥38℃,呼吸加快,鼻翼扇动,三凹征明显,X线胸片证实为叶性或节段性肺炎,除外慢性支气管肺疾病或免疫抑制,痰培养明确为细菌感染。 1.2方法 患儿入院第1天及治疗后1周抽取静脉血,采集静脉血后,立即离心分离血清,24 h内测定。CRP采用德国产CRP检测仪器(ADVIAl650)及浙江伊利康生物技术公司生产的CRP检测试剂盒。WBC采用美国Coulter公司ACT.5DIFF型全自动血细胞分析仪。ESR采用Western blot法检测。 1.3 统计学处理 计量资料数据以均数±标准差(x±s)表示,采用SPSS 13.0软件分析,采用χ2检验或t检验,P0.05)。见表2。 表1 细菌性肺炎3