儿童哮喘急性发作时血清C-反应蛋白浓度变化及临床意义

目的探讨血清C-反应蛋白(CRP)在儿童哮喘急性发作时的浓度变化及其临床意义。方法检测182例支气管哮喘急性发作患儿和50例非感染患儿的血清CRP和总IgE浓度,根据发病诱因,将哮喘急性发作患儿分为过敏诱发组、病毒感染诱发组和细菌感染诱发组,检测哮喘患儿血清过敏原特异性IgE,分析各组患儿及正常儿童的血清CRP变化。结果在哮喘急性发作时,细菌感染诱发组患儿的血清CRP水平最高(19.55±17.61)mg/L,过敏诱发组(5.45±4.32)mg/L、病毒感染诱发组(8.61±8.03)mg/L轻度升高,与正常对照组(1.61±1.25)mg/L相比,差异均有统计学意义(P均<0.001)。正常对照组、过敏诱发组、病毒感染诱发组、细菌感染诱发组儿童所对应的血清CRP水平分别为0～2 mg/L、2～10 mg/L、5～16 mg/L、≥16 mg/L,当CRP≥16 mg/L时应考虑发作诱因为细菌感染的可能性大。血清CRP、总IgE及食物呼吸过敏原之间没有显著性关系。结论过敏诱发、病毒感染诱发哮喘急性发作血清CRP浓度范围一般为2～10 mg/L、5～16 mg/L,哮喘急性发作时血清CRP≥16 mg/L时注意细菌感染及合并肺炎。

The concentration of serum C-reactive protein in asthmatic children during acute attack and its clinical significance

Objective To detect the concentrations of serum C-reactive protein(CRP)in children during acute asthma attack for investigating its clinical significance.Methods Serum CRP and IgE were detected in 182 asthmatic children in acute phase and 50 healthy children.The asthmatic children were divided into allergen-induced group,viral infection-induced group,bacterial infection-induced group.Allergen specific IgE(sIgE)were detected in asthmatic children.The serum CRPs were compared among subgroups of asthmatic children and healthy children.The relationship of CRP,IgE and sIgE was analyzed.Results The bacterial infection-induced group had the highest serum CRP(19.55 ± 17.61 mg/L),followed by allergen-induced group 5.45 ± 4.32 mg/L and viral infection-induced group(8.61 ± 8.03 mg/L).All of them had a significantly higher serum CRP than healthy children(1.61 ± 1.25)mg/L(P < 0.001).The serum CRP concentration range of healthy group,allergen-induced group,viral infection-induced group and bacterial infection-induced group were 0 ～ 2 mg/L,2 ～ 10 mg/L,5 ～ 16 mg/L,≥ 16 mg/L respectively.If the serum CRP level ≥ 16 mg/L,bacterial infection should be highly suspected.No relationship was observed between serum CRP,IgE and sIgE.Conclusions The concentrations of serum CRP are generally at 2 ～ 10 mg/L,5 ～ 16 mg/L in allergy induced and viral infection-induced asthmatic children.When the acute asthmatic children had a serum CRP level ≥ 16 mg/L,probably had been induced by bacterial infection and combined pneumonia.