血清降钙素原联合C反应蛋白检测在婴幼儿重症肺炎的临床价值

目的：探讨血清降钙素原联合C反应蛋白检测对婴幼儿重症肺炎早期诊断及判断病情严重程度的价值。方法选取2011年1月～2013年12月收治于本院儿童重症监护病房（PICU）的68例婴幼儿重症肺炎患者，患儿的年龄为30d～3岁，将其定为观察组，其中细菌性肺炎者40例，病毒性肺炎者18例，支原体肺炎者10例。选取同期于本院进行体检的30名健康婴幼儿，将其定为对照组。观察组在入住PICU的第1、3天进行血清降钙素原（PCT）、C反应蛋白（CRP），以及外周血白细胞（WBC）检测，将检测结果与对照组进行分析比较。结果观察组患儿的PCT、CRP和WBC的检测结果均明显高于对照组（P＜0.05），在血清降钙素原检测中，细菌性肺炎患儿的阳性率为90.00%，血清水平显著高于对照组；在C反应蛋白检测中，细菌性肺炎患儿的阳性率为95.00%，支原体肺炎患儿的阳性率为90.00%，两组的血清水平均明显高于病毒性肺炎患儿。结论在婴幼儿重症肺炎早期，血清降钙素原和C反应蛋白检测的阳性检出率均较高，其为婴幼儿重症肺炎的早期鉴别诊断及判断病情严重程度提供帮助，为临床医师及时、合理使用抗生素提供了可靠依据。

Clinical value of detection of serum procalcitonin and C reactive protein in infants with severe pneumonia

Objective To investigate the clinical value of serum procalcitonin values combined with C reaction protein in early diagnosis and judgement of disease severity of infants with severe pneumonia. Methods 68 cases of infant with severe pneumonia received and treated in the pediatric intensive care unit（PICU） of the present hospital from January 2011 to December 2013 were selected. The ages of the children were 30d to 3 years old, which were set as the observation group and included 40 cases of bacterial pneumonia, 18 cases of viral pneumonia and 10 cases of mycoplasma pneumonia. 30 healthy infants in the hospital for examination were set as the control group in the same periods. In the observation group, levels of serum procalcitonin（PCT）, C reactive protein（CRP）, and peripheral white blood cell（WBC） were detected at the first and third day after in PICU of the hospital, which were compared with that of the control group. Results The levels of PCT, CRP and WBC in observation group were all significantly higher than those in the control group（P 〈 0.05）. In the examination of serum procalcitonin, the positive rate of children with bacterial pneumonia was 90.00%, and the level of serum was significantly higher than that of the control group;In the detection of C reactive protein in children, the positive rate of children with bacterial pneumonia was 95.00%, and the positive rate of children with mycoplasma pneumonia was 90.00%. Conclusion Early in infants with severe pneumonia, serum procalcitonin and C reactive protein detection positive rate is higher, the help for the early diagnosis and prognosis of infants with severe pneumonia severity, and provide reliable basis for clinical rational use of antibiotics in time.