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目的:分析血清降钙素原、C反应蛋白水平在小儿肺炎合并全身炎症反应综合征及严重脓毒症患者中的临床意义。方法:选择2012年3月~2015年1月诊断为小儿肺炎患者120例,依据患者病情程度分为普通小儿肺炎组(普通组)40例,小儿肺炎合并全身炎症反应综合征组(SIRS组)40例,小儿肺炎合并严重脓毒症组(危重组)40例。患者入院后24h内均给予晨空腹抽取静脉血,电化学发光法检测血清降钙素原(PCT),免疫比浊法检测血清C反应蛋白(CRP)水平。比较3组患者血清中PCT、CRP水平差异。记录3组患者小儿危重病例评分(PCIS),Spearman相关系数计算血清PCT、CRP水平与PCIS之间相关性。结果:普通组、SIRS组与危重组患者血清PCT水平[(0.43±0.08)ng/mL比(1.48±0.36)ng/mL比(3.95±0.71)ng/mL,F=3.095],CRP[(8.38±1.25)mg/L比(15.93±2.90)mg/L比(23.64±3.91)mg/L,F=2.718]水平逐渐升高,3组比较差异有统计学意义(P<0.05)。血清PCT、CRP水平与PCIS呈显著负相关(r=-0.817,-0.518,P<0.05)。结论:血清降钙素原、C反应蛋白水平与小儿肺炎病情严重程度关系密切,入院后关注患者血清降钙素原与C反应蛋白水平变化有助于小儿肺炎患者病情严重性判断。
Objective: To analyze the clinical significance of serum procalcitonin and C-reactive protein levels in children with pneumonia complicated with systemic inflammatory response syndrome and severe sepsis. Methods: One hundred and twenty patients diagnosed as pediatric pneumonia were selected from March 2012 to January 2015. According to the severity of their illness, they were divided into general pneumonia group (40 cases), pediatric pneumonia complicated with systemic inflammatory response syndrome group (SIRS group) 40 cases, pediatric pneumonia with severe sepsis group (critically ill group) 40 cases. The patients were given fasting morning fasting venous blood 24h, electrochemiluminescence detection of serum procalcitonin (PCT), immunoturbidimetry detection of serum C-reactive protein (CRP) level. The differences of serum PCT and CRP levels in three groups were compared. Record the pediatric critical illness score (PCIS), Spearman correlation coefficient of three groups of patients to calculate the correlation between serum PCT, CRP level and PCIS. Results: The serum levels of PCT (0.43 ± 0.08) ng / mL (1.95 ± 0.71) ng / mL (3.95 ± 0.71) ng / mL in the SIRS group and the critically ill group were significantly higher than those in the control group 8.38 ± 1.25) mg / L (15.93 ± 2.90) mg / L (23.64 ± 3.91) mg / L, F = 2.718]. The difference between the three groups was statistically significant (P <0.05). Serum PCT, CRP levels were significantly negatively correlated with PCIS (r = -0.817, -0.518, P <0.05). Conclusion: Serum procalcitonin and C-reactive protein levels are closely related to the severity of pneumonia in children. Serum levels of procalcitonin and C-reactive protein in patients after admission are helpful to determine the severity of pneumonia in children.