降钙素原及C-反应蛋白在支原体肺炎中的变化及意义

目的 探讨支原体肺炎患儿血清降钙素原(PCT)、C反应蛋白(CRP)的变化及其临床意义.方法 选取2014年5月至2015年6月确诊的60例支原体肺炎患儿(支原体组)、60例细菌性肺炎患儿(细菌组)作为研究对象,60例年龄、性别基本一致的健康儿童作为健康组,检测并比较3组血清PCT、CRP的水平并进行比较分析.结果细菌组患儿血清PCT、CRP水平显著高于支原体组、健康组,差异均有统计学意义(P<0.05);支原体组血清PCT、CRP水平显著高于健康组,差异均有统计学意义(P<0.05);绘制ROC曲线,取血清PCT值为0.32 ng/ml时,PCT鉴别诊断支原体、细菌性肺炎的灵敏度为72.06%、特异性为77.29%、ROC曲线下面积AUC值为0.823;取血清CRP值为21.98 mg/L时,CRP鉴别诊断支原体、细菌性肺炎的灵敏度为67.97%、特异性为74.20%、ROC曲线下面积AUC值为0.795;支原体肺炎患儿急性期的血清PCT、CRP水平均显著高于缓解期,差异有统计学意义(P<0.05).结论血清PCT、CRP检测能够对临床鉴别诊断支原体肺炎和细菌型肺炎具有一定的临床价值,同时可以判断肺炎支原体患儿的病情变化.

Changes of serum levels of procalcitonin and C reactive protein in children patients with mycoplasma pneumonia and its clinical significance

Objective To investigate the changes of serum levels of procalcitonin ( PCT ) and C reactive protein ( CRP) in children patients with mycoplasma pneumonia ( MP) and its clinical significance .Methods Sixty children patients with MP who were diagnosed and treated in our hospital from May 2014 may to June 2015 were enrolled as MP group ,the other 60 children patients with bacterial pneumonia were enrolled as bacterial pneumonia group ,moreover, the 30 healthy children were served as control group .The serum levels of PCT and CRP were detected and compared among the three groups .Results The serum levels of PCT and CRP in bacterial pneumonia group were significantly higher than those in MP group and control group ( P <0.05),moreover,which in MP group were significantly higher than those in control group ( P <0.05).When serum PCT value was 0.32ng/ml,the sensitivity of PCT in differential diagnosis between bacterial pneumonia and MP was 72.06%,specificity was 77.29%,the area under ROC curve was 0.823 (AUC value);when serum CRP value was 21.98mg/L, the sensitivity of PCT in the differential diagnosis between bacterial pneumonia and MP was 67.97%,specificity was 74.20%, the area under ROC curve was 0.795 ( AUC value),the serum levels of PCT and CRP in mycoplasma pneumonia at acute phase were significantly higher than those in remission phase ( P <0.05).Conclusion The detection of serum levels of CRP and PCT has certain clinical significance in differential diagnosis between MP and bacterial pneumonia ,at the same time ,which can evaluate the changes of patient ' s condition .