儿童哮喘急性发作时血清C反应蛋白的变化(1)
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[摘要] 目的 探讨检测血清C反应蛋白在儿童哮喘急性发作时诊断、预测以及治疗中的临床意义。方法 选择2009~2010年来本院就诊的支气管哮喘儿童患者112例作为病例研究组，以同期120例正常儿童作为对照组。分别于糖皮质激素治疗前后进行血浆CRP测定和白细胞计数。 结果 支气管哮喘急性发作组与正常对照组间比较，白细胞计数和血浆CRP有显著升高，P < 0.01；支气管哮喘急性发作组治疗前与治疗后相比，白细胞计数有显著减少，同时血浆CRP浓度也显著减少，P < 0.01。结论 血浆CRP不仅是一种潜在的支气管哮喘患者急性发作的标志物，同时可作为支气管哮喘急性发作治疗效果的一种评判指标。
[关键词] 儿童；支气管哮喘；C反应蛋白；诊断
[中图分类号] R562.2+5 [文献标识码] A [文章编号] 1674-4721(2012)03(c)-0036-02
Changes of serum C-reactive protein in acute attack of children with asthma
XIE Xiaofen ZHU Jieming
The Second People's Hospital of Liwan District in Guangzhou City in Guangdong Province, Guangzhou 510160, China
[Abstract] Objective To investigate the clinical significance of the detection of serum C-reactive protein (CRP) in the diagnosis, prediction and treatment of acute attack of pediatric asthma. Methods One hundred and twelve pediatric patients with bronchial asthma admitted to our hospital from 2009 to 2010 were chosen as study group, and 120 normal children in the same period were chosen as control group. Determination of plasma CRP and leukocyte count before and after treatment of glucocorticoid were assessed respectively. Results Compared with control group, the white blood cell count and plasma CRP in the study group were increased significantly (P < 0.01); compared with before treatment, the leukocyte count and the concentration of plasma CRP after treatment in the study group were reduced significantly (P < 0.01). Conclusion Plasma CRP is not only a potential marker for children with bronchial asthma, but also an evaluation index for the treatment effect of acute attack of pediatric asthma.
[Key words] Children; Bronchial asthma; C-reactive protein; Diagnosis
儿童支气管哮喘是儿科常见的一种临床疾病，它主要以支气管气道高反应性和可逆性气流受阻为特征，由炎性细胞、气道结构细胞和气道组分因素共同参与形成一种慢性炎症。呼吸道感染、过敏等均可以诱发哮喘急性发作，预防和减少急性发作是未来研究的焦点。C -反应蛋白(CRP)是一个急性时相蛋白，大量研究显示多种炎症、组织损伤、恶性肿瘤等疾病中均可升高。但目前为止有关哮喘急性发作和血清CRP间的关系尚不清楚[1]，该研究以2009~2010年来本院就诊的支气管哮喘儿童患者为研究对象，通过检测哮喘急性发作患儿血清中CRP的水平，探讨血清CRP浓度在哮喘急性发作诊断预测以及治疗中的临床意义。
1资料与方法
1.1 一般资料
回顾2009~2010年来本院治疗的年龄1～12岁的支气管哮喘患儿112例作为病例研究组，平均(7.14±3.67)岁；以同期来本院进行体检的120例正常儿童作为对照组，年龄1～13岁，平均(7.46±4.45)岁。儿童支气管哮喘诊断依据2008年制定的儿童支气管哮喘诊断与防治指南，哮喘急性发作是指诊断为支气管哮喘的儿童突然发生喘息、气促、咳嗽、胸闷等呼吸系统症状，或原有哮喘症状急剧加重。所有纳入研究患儿均无免疫功能低下，并且近2周内未使用过糖皮质激素类药物和免疫调节剂类药物。
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