伤寒患儿心肌酶谱改变及其临床意义

为进一步探讨小儿伤寒心肌损害的临床意义，我们对40例伤寒患儿进行系统的临床观察及心肌酶谱检测研究，现将结果报告如下。     

急性豆角中毒患儿血清心肌酶谱检测及临床意义

目的 了解急性豆角中毒患儿心肌损害情况.方法 以54例急性豆角中毒患儿为研究对象,根据症状轻重分成2组(轻症组24例,重症组30例),均于中毒后第3天晨起空腹抽静脉血,进行心肌酶谱检测.同时2组患儿均常规进行心电图检查.结果 轻症组血清乳酸脱氢酶(LDH)异常率为54.1%,肌酸激酶(CK)异常率为12.5%,CK-MB异常率为4.2%;而重症组血清LDH异常率为83.4%,CK异常率为55.3%,CK-MB异常率为33.3%;重症组LDH、CK、CK-MB异常率均显著高于轻症组(P＜0.05).结论 救治急性豆角中毒患儿时不能忽视心肌损伤.患儿心肌损害程度与中毒程度有关,心肌酶谱检测和心电图检查可辅助诊断.     

急性豆角中毒患儿血清心肌酶谱检测及临床意义

目的 了解急性豆角中毒患儿心肌损害情况.方法 以54例急性豆角中毒患儿为研究对象,根据症状轻重分成2组(轻症组24例,重症组30例),均于中毒后第3天晨起空腹抽静脉血,进行心肌酶谱检测.同时2组患儿均常规进行心电图检查.结果 轻症组血清乳酸脱氢酶(LDH)异常率为54.1%,肌酸激酶(CK)异常率为12.5%,CK-MB异常率为4.2%;而重症组血清LDH异常率为83.4%,CK异常率为55.3%,CK-MB异常率为33.3%;重症组LDH、CK、CK-MB异常率均显著高于轻症组(P＜0.05).结论 救治急性豆角中毒患儿时不能忽视心肌损伤.患儿心肌损害程度与中毒程度有关,心肌酶谱检测和心电图检查可辅助诊断.     

87例肺炎患儿心肌酶谱的临床分析

目的探讨小儿肺炎时心肌酶谱的变化，以指导临床。方法87例肺炎患儿进行心肌酶谱检测，同期门诊40例上呼吸道感染患儿作为对照组进行比较。结果肺炎患儿与上呼吸道感染患儿CK-MB值比较差异有统计学意义（P〈0．05），且小婴儿组差异有显著统计学意义（P〈0．01）。结论肺炎患儿心肌酶谱增高显著，年龄越小心肌酶谱水平越高，心肌损害越明显，对小婴儿肺炎患儿要早期，干预治疗。     

呼吸道感染患儿血清心肌酶谱的观察

为探讨心肌酶谱在小儿呼吸道感染时的变化规律和临床意义 ,我们对 15 4例各类呼吸道感染患儿心肌酶谱进行测定和比较 ,报道如下。对象和方法一、对象　新乡医学院第一、二附属医院儿科 1998年 2月～ 2 0 0 0年 3月住院患儿 ,男 73例 ,女 81例 ,年龄 2个月～9ａ ,平均年龄 2 .5 6± 2 .18ａ,其中上呼吸道感染 (上感 )组 6 9例 ,支气管哮喘 (支哮 )组 47例 ,肺炎组 2 7例 ,肺炎合并心衰组 (心衰组 ) 11例 ,诊断符合 1993年全国小儿呼吸道疾病学术会议制定的诊断标准。均于入院ｄ2早晨空腹、心衰组于心衰发生当日以及根据需要随时抽取静脉血送…     

轮状病毒肠炎患儿血清心肌酶谱的变化

目的探讨轮状病毒肠炎患儿心肌酶谱的改变及心肌损害的发生率。方法对2003年11月～2004年10月在我院住院的腹泻病患儿,用酶联免疫吸附试验(ELISA)方法测定其大便轮状病毒抗原,用酶速率法检测其心肌酶谱的改变。结果轮状病毒肠炎并心肌损害达90.63%,使用果糖二磷酸钠注射液治疗1周,肌酸磷酸激酶同工酶恢复正常达96.5%。结论轮状病毒可致心肌损伤,对轮状病毒肠炎患儿应警惕心肌损害的发生。     

窒息新生儿心肌酶谱检测的临床意义

本文对 2 0 0 1年 2～ 12月我院住院的 46例窒息新生儿及 19例同期出生的正常足月儿做血清LDH、CK、HBDH、CK MB定量测定 ,以探讨其对窒息新生儿心肌损害的诊断价值 ,现报告如下。资料与方法一、临床资料　 2 0 0 1年 2～ 12月于丹东妇女儿童医院出生及外院转入的窒息新生儿 46例。其中重度窒息组 19例(男 10例 ,女 9例 ) ,羊水Ⅲ度污染 13例 ,Ⅱ度污染 6例 ;轻度窒息组 2 7例 (男 14例 ,女 13例 ) ,羊水Ⅲ度污染、Ⅱ度污染、羊水清各 9例。胎龄 3 7～ 41周 ,出生体重 2 5 0 0～ 40 0 0 g ,诊断及分度均符合新生儿窒息诊断及分度标准[…     

流行性出血热患儿心肌酶谱检测结果分析

随着免疫抑制法测定血清磷酸肌酸激酶同工酶CK-MB技术的发展,此法作为诊断儿童病毒性心肌炎的主要指标之一,已在国内实验室广泛使用。本文将健康儿童CK-MB测定结果,分年龄、性别和健康成人进行统计分析比较如下。 资料与结果 健康体检儿童来自幼儿园、小学、初高中及单位体检者,半年内无呼吸道感染史,无心脏病史,经体检     

颅内感染患儿血和脑脊液C-反应蛋白检测的临床意义

目的：探讨血和脑脊液C-反应蛋白(CRP)的检测对颅内感染鉴别诊断的价值及其动态变化的临床意义。方法：92例诊断明确的各型颅内感染患儿，其中化脓性脑膜炎(化脑组)22例，病毒性脑(膜)炎组(病脑组) 40例，结核性脑膜炎组(结脑组) 30例，用免疫比浊法检测血清和脑脊液CRP浓度，并于治疗7～10 d后复查，另15例有神经系统症状但非颅内感染的患儿作对照组(其中热性惊厥8例，癫痫7例)。结果：化脑组治疗前、后血清CRP浓度分别与对照组、化脑组、病脑组、结脑组比较均有统计学意义，脑脊液CRP浓度各组间比较无统计学意义。结论：化脑组血清CRP浓度明显高于病脑组和结脑组，血清CRP 检测有助于化脑和病脑及结脑的鉴别。     

Human serum amyloid A (SAA) and high sensitive C-reactive protein (hsCRP) in preterm newborn infants with nosocomial infections

Human serum amyloid A (SAA) and high sensitive C-reactive protein (hsCRP) and their relation to suggestive nosocomial infections (NIs) were investigated in very preterm (VPT) newborn infants. In a retrospective analysis, information of suggestive NI was matched to levels of SAA and hsCRP in 224 serum samples from 72 VPT newborn infants. As a control group, 35 healthy-term newborn infants were chosen. Of the 224 serum samples, 145 samples were not associated with nosocomial infections. However, 79 were associated with NI: of these 79, 42 were found to be culture-proven NI. Trimmed mean (alpha= 0.05) levels for SAA and hsCRP in VPT newborn infants were higher than in control term newborn infants (1.74, 2.67 mg/L vs. 0.78, 0.16 mg/L; p = 0.01 and <0.0001, respectively), and higher in the NI group than in the non-NI group (5.14, 5.74 mg/L vs. 1.03, 1.18; p < 0.01 and <0.0001; respectively). The areas under the curve (AUC) for hsCRP, calculated from the receiver-operator characteristic (ROC) curves, was greater (0.816; 95% CI 0.759-0.864) than for SAA (0.610; 95% CI 0.543-0.675). CONCLUSION: Identifying and monitoring of bacterial and fungal infections in VPT might be further improved by the use of SAA and hsCRP.     

肺炎支原体肺炎C-反应蛋白检测的临床意义

目的探讨C-反应蛋白（CRP）在肺炎支原体肺炎中的临床意义。方法细菌性支气管肺炎和肺炎支原体肺炎患儿各60例，采用酶联免疫法检测其血清CRP。结果细菌性支气管肺炎组CRP阳性率为88．33％，肺炎支原体肺炎组CRP阳性率为13．33％，差异有非常显著性（P〈0．01）。结论CRP检测对肺炎支原体肺炎与细菌性肺炎的早期鉴别及临床用药有一定的指导意义。当肺炎支原体肺炎患儿CRP升高时，可考虑为肺炎支原体和细菌混合感染，或提示有较严重并发症的可能。     

CD64联合C-反应蛋白及降钙素原检测在新生儿败血症的临床研究

目的 研究CD64联合C-反应蛋白(C-reactive protein,CRP)及降钙素原(procalcitonin, PCT)检测对新生儿败血症临床诊断的意义.方法 选取福建医科大学附属福州市第一医院儿科2015年3月至2016年6月收治的经临床确诊为新生儿败血症的70例患儿为败血症组、35例非感染性疾病患儿为非感染组、40例健康新生儿为健康对照组.通过流式细胞仪检测各组新生儿血液CD64,全自动生化分析仪检测血清CRP和PCT,并进行对比分析.结果 败血症组新生儿全血CD64、血清CRP和PCT均显著高于非感染组和健康对照组新生儿(P<0.05);CD64、CRP和PCT联合诊断败血症的敏感性和特异性分别为97.14%和96.00%,均高于3项指标单独诊断新生儿败血症的敏感性和特异性.结论 联合检测CD64、CRP和PCT可以提高新生儿败血症诊断的特异性,为临床早期诊断提供依据.     

儿童肥胖与C-反应蛋白瘦素胰岛素敏感指数的相关性研究

目的：探讨儿童肥胖与超敏C反应蛋白(hsCRP)、瘦素(LP)、胰岛素敏感指数(ISI)的相关性。方法：抽样调查湘潭市13702名2～18岁儿童及青少年，将69名肥胖自愿者及30名年龄、性别相匹配的自愿受试者分为两组，分别测体重指数(BMI)、hsCRP，LP，空腹血糖(FPG)、空腹胰岛素(INS)，计算ISI，比较两组差异及各指标的相关性。结果：肥胖组hsCRP，INS，LP显著高于对照组(P<0.01)，ISI显著低于对照组(P<0.01)；BMI与hsCRP，LP，INS呈显著正相关(P<0.05～0.01)，与ISI呈显著负相关(P<0.01)，hsCRP与FPG，INS呈显著正相关(P<0.05～0.01)，与ISI呈显著负相关(P<0.01)；LP与INS，BMI呈显著正相关(P<0.01)，与ISI呈显著负相关(P<0.01)。结论：肥胖儿童存在胰岛素抵抗(IR)及瘦素抵抗(LR)，同时CRP，LP等炎症因子在肥胖发病过程中起重要作用。     

Utility of haematological parameters and C-reactive protein in the detection of neonatal sepsis

OBJECTIVE: To evaluate various haematological parameters, individually and in combination, to formulate a haematological scoring system (HSS, defined by Rodwell et al.), which can then be used to screen for sepsis in neonates who are clinically suspected of infection.1 METHODS: The study cohort consisted of 150 neonates (from birth to 3 days old) with clinically suspected infection. Blood was collected by peripheral venepuncture in all neonates. A complete blood count, differential leucocyte count, total leucocyte count (TLC), total neutrophil count (TNC), immature neutrophil count, band form count and platelet count were performed. Immature total neutrophil count (I/T) and immature/mature neutrophil count (I/M) ratios were then obtained. C-reactive protein (CRP) was measured semiquantitatively and blood culture and antibiotic sensitivity were performed in each case. The haematological parameters were compared individually and in combination (by HSS) with CRP. RESULTS: Twenty-one (14%) neonates had blood culture proven sepsis. On evaluation of various haematological parameters, TLC < 10 x 109/L, TNC < 8 x 109/L, I/M > 0.25, I/T > 0.14, band count > 15% and platelet count < 150 x 109 were found to have optimal sensitivities and negative predictive values (NPV). Using these values, an HSS was formulated. A haematological score > or = 3 had a sensitivity of 86% and NPV of 96%. C-reactive protein as a single test had a sensitivity of 76% and NPV of 96%. A combination of CRP with haematological parameters decreased the sensitivity and NPV of the HSS. CONCLUSIONS: A haematological score can be obtained by a complete blood count and examination of peripheral blood smear, thus permitting an objective assessment of haematological changes that occur in a neonate suspected of sepsis. C-reactive protein does not have any advantage over HSS, either as a single test or in combination.     

降钙素原、C反应蛋白正常的婴幼儿细菌性肺炎临床分析

目的探讨降钙素原(PCT)、C反应蛋白(CRP)正常的婴幼儿细菌性肺炎的临床特点。方法比较2013年1月1日至2015年3月30日期间,92例PCT、CRP正常(病例组)与95例PCT、CRP明显升高(对照组)的婴幼儿细菌性肺炎患儿的临床资料。结果病例组的月龄中位数为9.25个月,低于对照组的16.55个月,院前病程中位数为5.17 d,长于对照组的3.50 d;差异均有统计学意义(P0.05)。病例组患儿发热、呼吸增快、低氧血症比例明显少于对照组,差异有统计学意义(P0.05)。83.69%的病例组患儿院外使用抗生素,明显高于对照组,差异有统计学意义(P0.05)。病例组的病原菌以流感嗜血杆菌最多,对照组则以肺炎链球菌最为常见。结论婴幼儿肺炎患儿PCT、CRP均正常仍不能排除细菌性肺炎的可能。     

急性上呼吸道感染患儿外周血C-反应蛋白的测定及临床意义

目的　 探讨C 反应蛋白 (CRP)对急性上呼吸道感染患儿在诊断和治疗中的临床意义。 方法 　选择 373例在急诊科就诊的患儿 ,采集指端全血 40 μL ,进行血常规检查 ,同时用免疫比浊方法进行C 反应蛋白检测 ,将测定的CRP结果与WBC计数做比较 ;将第二次、第三次测定的CRP结果与前次的CRP做比较。 结果 　 373例血标本中CRP <8mg/L 341例 ,占 91 4 2 %;CRP >10 0mg/L 4例 ,占 1 0 7%;CRP在 8～ 10 0mg/L 2 8例 ,占 7 5 1%;WBC计数在 10× 10 9/L以下 318例 ,占 85 2 6 %;CRP <8mg/L ,同时WBC数在 10× 10 9/L以上 35例 ,占 9 38%;CRP≥ 8mg/L ,同时WBC数在 10× 10 9/L以下 12例 ,占 3 2 2 %;第二次测定C 反应蛋白的 32例中较前次降低的为 30例 ;另 2例经调整治疗后第三次复查也较前次降低。 结论 　CRP检测在急性上呼吸道感染患儿中对鉴别细菌或病毒感染以及判定抗生素疗效方面具有较高的价值 ,值得推广。     

青春期多囊卵巢综合征患者血清超敏C反应蛋白与临床各因素的相关性分析

目的探讨青春期多囊卵巢综合征(PCOS)患者血清中超敏C反应蛋白(hs-CRP)水平与临床各因素之间的相关性。方法选择36例PCOS患者,17例为PCOS肥胖组(BMI≥25 kg/m2),19例PCOS非肥胖组(BMI<25 kg/m2),另选15例正常少女为对照组。检测血清hs-CRP、性激素、血脂、血糖、胰岛素等,并进行比较和相关性分析。结果 PCOS肥胖组患者的hs-CRP水平明显高于PCOS非肥胖组(P<0.05)和正常对照组(P<0.01)。Spearman相关分析显示,hs-CRP与BMI、腰臀比、睾酮、三酰甘油呈正相关(P均<0.05);与胰岛素抵抗指数、胰岛素敏感指数无相关性(P均>0.05)。结论 PCOS肥胖患者体内可能存在着慢性低强度炎症,CRP可以反应其肥胖和高雄激素血症的严重程度。     

Early high C-reactive protein in infants with open abdominal wall defects does not predict sepsis or adverse outcome

Aim:  To study CRP values and relate it to outcome in infants with antenatal diagnosis of gastroschisis, exomphalos and other surgical conditions.
Methods:  Over five years, infants admitted to our neonatal unit with gastroschisis, exomphalos and other surgical diagnoses were identified. Serum CRP measurements in first 5 days were studied. Group one included 33 gastroschisis patients, group two, 18 exomphalos patients, and group three, 38 patients with other surgical diagnoses. Outcome measures included TPN days, time to full feeds and duration of hospitalization.
Results:  Infants with gastroschisis were more premature (36.9 vs 38.1 weeks) with lower birth weights (2515 vs 3078 g), than infants with exomphalos. CRP values on admission in gastroschisis group were significantly higher than exomphalos and other diagnoses groups (33.7 ± 6.4 vs 8.8 ± 6.0 vs 5.7 ± 2.0, respectively, p   <   0.05). All blood cultures were sterile. There was no relationship between high CRP and death or adverse outcome (TPN days, time to full feeds or duration of hospitalization) in the gastroschisis group.
Conclusion:  Infants with gastroschisis exhibit high early CRP, which may not indicate sepsis or adverse outcome. This increase can complicate the assessment of these infants. Clinicians should be aware of this finding as it could inform management decisions in this group.