摘要
目的探讨血清降钙素原(PCT)、C反应蛋白(CRP)水平对小儿病毒性肺炎患者病情判断与相关性分析。方法选择2017年1月-2019年1月我院收治的急性小儿病毒性肺炎患者250例为研究对象,按病情严重程度分为普通组198例和危重组52例。计算2组入院当日急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ),检测2组血清PCT、CRP水平并计算每24 h血清PCT、CRP水平变化率。分析血清PCT、CRP水平与APACHEⅡ评分相关性,及血清PCT水平变化率对小儿病毒性肺炎预后判断价值。结果入院第2、3、5、7天危重组血清PCT、CRP及入院第1天CRP水平高于普通组(P<0.05)。发病后危重组血清PCT、CRP及普通组CRP水平先升高后下降,普通组血清PCT水平无明显变化。2组不同时间点血清CRP水平变化与血清PCT变化规律不同步。入院72 h血清PCT、CRP水平与APACHEⅡ评分呈直线正相关(r=0.821、0.426,P<0.05)。入院48 h血清PCT≥0.84 ng/ml,72 h血清PCT水平变化率升高幅度≥75%对于小儿重症病毒性肺炎诊断和预后判断价值较大。结论血清PCT水平可作为早期评价急性小儿病毒性肺炎病情严重程度分类依据;入院72 h内血清PCT水平升高幅度变化率可以作为小儿病毒性肺炎病情预后判断指标。
Objective To investigate serum procalcitonin(PCT)and C-reactive protein(CRP)levels in evaluating the severity of children with viral pneumonia and their correlation.Methods From January 2017 to January 2019,250 cases of children with acute viral pneumonia in our hospital were selected as the research subjects.According to the severity of the disease,they were divided into general group(n=198)and critical group(n=52).The acute physiology and chronic health score systemⅡ(APACHEⅡ)of two groups was calculated on the day of admission.The serum PCT and CRP levels of the two groups were detected,and the change rate of serum PCT and CRP levels every 24 h was calculated.The correlation of serum PCT and CRP levels with ApacheⅡscore,as well as the prognostic value of serum PCT level change rate was analyzed.Results The levels of serum PCT,CRP at 2,3,5 and 7 days after admission and CRP level on the day of admission were higher than those in the general group(P<0.05).After the onset of the disease,the levels of serum PCT and CRP in the critical group as well as CRP level in the general group were increased and then decreased,while the serum PCT level in the general group did not change significantly.The changes of serum CRP and PCT were not synchronous in the two groups at different time points.There was a linear positive correlation between serum PCT,CRP levels and ApacheⅡscore(r=0.821;0.426,P<0.05).Change rate of PCT≥0.84 ng/ml at 48 h and≥75%at 72 h after admission were of great value in the diagnosis and prognosis of severe viral pneumonia in children.Conclusion The serum PCT level can be used for early evaluation of the severity of acute viral pneumonia in children.The change rate of serum PCT level within 72 h after admission can be used as a prognostic indicator of viral pneumonia in children.
作者
范中娥
刘媛
范方勇
范中欣
马国妹
郑丽
代树栋
FAN Zhong-e;LIU Yuan;FAN Fang-yong;FAN Zhong-xin;MA Guo-mei;ZHENG Li;DAI Shu-dong(Department of Pediatrics,Huanghua People's Hospital,Huanghua,Hebei 061100,China;Department of Obstetrics and Gynecology,Huanghua Maternal and Child Health and Family Planning Service Center,Huanghua,Hebei 061100,China;Department of Otolaryngology,Boai Hospital,Huanghua Development Zone,Huanghua,Hebei 061100,China)
出处
《解放军医药杂志》
CAS
2020年第11期49-53,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
河北省中医药管理局科研计划项目(2019311)。
关键词
肺炎
病毒性
降钙素原
C反应蛋白
变化率
预后
诊断
相关性分析
Pneumonia,viral
Procalcitonin
C-reactive Protein
Change rate
Prognosis
Diagnosis
Correlation analysis
