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目的检测临床常用炎性指标C反应蛋白、白细胞和中性粒细胞的变化,探讨它们与儿童肺炎之间的关系,从而鉴别病原、帮助诊断、指导治疗。方法收集支气管肺炎患儿550例,采用速率散射比浊法测定C反应蛋白水平,同时进行血常规及相关病原学检查。结果①C反应蛋白升高者192例占35.02%,治疗5d后复查C反应蛋白降至正常者171例占89.09%,治疗前后C反应蛋白均值比较差异有统计学意义(P<0.001)。②痰或血培养提示细菌生长者40例占7.20%,其中C反应蛋白升高者35例占88.46%;血支原体阳性者14例占2.52%,其中C反应蛋白升高者10例占75.00%,二者C反应蛋白均值比较差异有统计学意义(P<0.05)。③白细胞或中性粒细胞百分比升高者242例,其中C反应蛋白升高者118例占48.57%;白细胞或中性粒细胞均不升高者308例,其中C反应蛋白升高者75例占24.35%,二者C反应蛋白升高率比较差异有统计学意义(P<0.01)。结论观察血C反应蛋白、白细胞、中性粒细胞等临床常用炎性指标变化对鉴别儿童肺炎病原、帮助指导诊断与临床治疗具有重要意义。
Objective To detect the changes of clinically used inflammatory markers C-reactive protein, leukocyte and neutrophil, to explore their relationship with childhood pneumonia, in order to identify the pathogen, to help diagnose and guide the treatment. Methods 550 cases of children with bronchial pneumonia were collected. The level of C-reactive protein was measured by rate nephelometry. Blood routine and related etiological examination were also performed. Results ① 192 cases of elevated C-reactive protein accounted for 35.02%. After 5 days of treatment, 171 cases (89.09%) had C-reactive protein returned to normal after treatment. There was significant difference in C-reactive protein between before and after treatment (P <0.001). Sputum or blood culture tips bacterial growth in 40 cases accounted for 7.20%, of which 35 cases of elevated C-reactive protein accounted for 88.46%; 14 cases of blood-mycoplasma positive accounted for 2.52%, of which elevated C-reactive protein in 10 cases accounted for 75.00% , The difference of C-reactive protein between the two groups was statistically significant (P <0.05). ③ The percentage of leukocytes or neutrophils increased in 242 cases, of which 118 cases of elevated C-reactive protein accounted for 48.57%; 308 cases of leucocytes or neutrophils were not elevated, including elevated C-reactive protein in 75 cases Accounting for 24.35%. There was a significant difference in the rate of C-reactive protein between the two groups (P <0.01). Conclusions It is of great significance to observe the change of common clinical indexes such as blood C-reactive protein, leucocyte and neutrophil in differentiating the pathogen of pneumonia in children and help to guide the diagnosis and clinical treatment.