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目的探讨全程C-反应蛋白(CRP)[常规CRP和超敏CRP(hsCRP)]在儿童急性细菌性脑膜炎临床诊治中的应用价值。方法2008年10月至2011年10月于河北省张家口市崇礼县医院就诊的43例急性细菌性脑膜炎患儿,分别于开始治疗前及治疗后第1、5天检测外周血白细胞计数、中性粒细胞计数和全程CRP,并行脑脊液常规和生化检查,对治疗前后外周血象、全程CRP和脑脊液中白细胞、蛋白、糖检测结果进行比较。结果细菌性脑膜炎患儿经积极有效治疗后,全程CRP在短期内迅速下降,变化显著,而外周白细胞计数、中性粒细胞计数、脑脊液各项指标的变化滞后于全程CRP。结论全程CRP在小儿急性细菌性脑膜炎诊治中有很高敏感性,对疾病早期诊断有临床意义。
Objective To investigate the value of full C-reactive protein (CRP) [routine CRP and hsCRP] in the clinical diagnosis and treatment of acute bacterial meningitis in children. Methods From October 2008 to October 2011, 43 children with acute bacterial meningitis were treated in Chongli County Hospital of Zhangjiakou City, Hebei Province. Peripheral blood leukocyte counts were measured before treatment and on the first and fifth day after treatment. Neutrophil count and full CRP, parallel cerebrospinal fluid routine and biochemical tests, before and after treatment of peripheral blood, whole blood CRP and cerebrospinal fluid leukocyte, protein, sugar test results were compared. Results After active and effective treatment of children with bacterial meningitis, CRP decreased rapidly in the short term, and the changes were significant. However, the change of peripheral white blood cell count, neutrophil count and cerebrospinal fluid lagged the whole CRP. Conclusion The whole CRP is highly sensitive to the diagnosis and treatment of acute bacterial meningitis in children and has clinical significance for the early diagnosis of the disease.