C-反应蛋白联合降钙素原检测鉴别肺部感染病原体的临床价值(1)
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【摘要】 目的：探讨C-反应蛋白(CRP)联合降钙素原(PCT)检测对鉴别肺部感染病原体的临床价值。方法：收集明确诊断为肺部感染儿童116例，分别于入院时以及抗感染治疗7 d后，抽取空腹静脉血检测CRP和PCT；同时对所有患者在使用抗生素前进行纤维支气管镜下取痰标本送培养以明确病原体。结果：(1)入院时，细菌感染患儿血浆PCT水平明显高于真菌和病毒感染者(P<0.05)，3种病原体感染的患儿的血浆CRP水平均呈现相似程度的升高；(2)抗感染治疗7 d后，细菌感染患儿血浆PCT水平较入院时明显下降(P<0.05)；与入院时相比，细菌和病毒感染患儿的CRP水平均下降明显(P<0.05)，而真菌感染患儿下降幅度不明显。结论：肺部感染儿童，联合检测血浆CRP和PCT水平，并动态观察CRP和PCT水平变化，能够有利于感染病原体的鉴别，同时还能够评估抗感染的疗效。
【关键词】 C-反应蛋白； 降钙素原； 肺部感染
Clinical Value of the Combined Detection of CRP and PCT on the Differential Diagnosis of Pathogens in Patients with Pulmonary Infection/CHEN Fei.//Medical Innovation of China，2012，9(12)：091-092
【Abstract】 Objective： To investigate the clinical value of the combined detection of CRP and PCT on the differential diagnosis of pathogens in children with pulmonary infection. Methods： 116 children defined as pulmonary infection were enrolled and fasting blood were drawn to evaluate the levels of CRP and PCT on the initial admission and 7 days after therapy. All the sputum specimens were collected with the use of fiberoptic bronchoscopy before the antibiotics prescriptions and were used to define the pathogens. Results： (1) On the initial admission， the levels of PCT in patients with bacterial infection were significantly higher than those in fungal and viral infections(P<0.05)， and the levels of CRP in all 3 pathogens infection similarly increased(P<0.05). (2) 7 days after therapy， the levels of PCT in patients with bacterial infection were reduced significantly(P<0.05)， and compared to the level of CRP on the initial admission， the levels of CRP in the bacterial and viral infections significantly reduced(P<0.05)， while those in the patients with fungal infection reduced less significantly. Conclusion： The combined detection and dynamically monitor of CRP and PCT levels in children with pulmonary infection is beneficial to identify the pathogens and is value to evaluate the efficacy of therapy.
【Key words】 C-reactive protein； Procalcitonin； Pulmonary infection
First-author’s address： Lianjiang Maternal and Child Health Hospital in Guangdong Province ......
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