CAJ | 학술논문

目的：探讨C－反应蛋白（ CRP）、前清蛋白（ PA）及白细胞计数（ WBC）水平测定在感染性疾病患儿诊断治疗中的临床意义。方法选择2011年9月至2013年9月于瑞安市人民医院进行治疗的72例感染性疾病患儿作为研究对象，其中36例细菌性感染患儿（细菌组），36例病毒性感染患儿（病毒组），所有患者均给予对症治疗，比较两组患儿在治疗前后血清CRP、PA及WBC水平，选取36例健康体检儿童作为对照。结果治疗前细菌组血清CRP、WBC水平明显高于病毒组及对照组，血清PA水平显著低于病毒组及对照组（与病毒组相比，tCRP ＝10．68，tWBC ＝4．96，tPA ＝11．32；与对照组相比，tCRP ＝11．75，tWBC ＝5．37，tPA ＝12．08；均P＜0．05），治疗后3组均无统计学差异（FCRP ＝1．75，FWBC ＝2．07，FPA ＝2．04；均P＞0．05）；治疗后细菌组血清CRP、PA及WBC水平与治疗前比较均有统计学差异（tCRP ＝9．478，tWBC ＝5．11，tPA ＝12．34；均P＜0．05）；以CRP≥8mg／L，WBC≥10×109／L，PA≤165mg／L为阳性，感染性疾病患儿中CRP、WBC、PA细菌组阳性率与病毒组和对照组比较，差异均有统计学意义（与病毒组比较χ2CRP ＝10．90，χ2WBC ＝4．13，χ2PA ＝20．63；与对照组比较χ2CRP ＝22．86，χ2WBC ＝7．60，χ2PA ＝28．68；均P＜0．05），病毒组与对照组比较，差异均无统计学意义（χ2CRP ＝1．35，χ2WBC ＝0．73，χ2PA ＝0．63；均P＞0．05）。各组指标经相关性分析发现，CRP与WBC之间呈现直线正相关（r＝0．56，P＜0．01），PA与CRP以及PA与WBC之间均呈现负相关（r值分别为－0．51，0．23，均P＜0．01）。结论 CRP、PA及WBC联合检测对感染性疾病患儿诊断治疗具有重要临床意义，CRP、PA水平变化可作为反映儿童细菌感染敏感指标。
목적：탐토C－반응단백（ CRP）、전청단백（ PA）급백세포계수（ WBC）수평측정재감염성질병환인진단치료중적림상의의。방법선택2011년9월지2013년9월우서안시인민의원진행치료적72례감염성질병환인작위연구대상，기중36례세균성감염환인（세균조），36례병독성감염환인（병독조），소유환자균급여대증치료，비교량조환인재치료전후혈청CRP、PA급WBC수평，선취36례건강체검인동작위대조。결과치료전세균조혈청CRP、WBC수평명현고우병독조급대조조，혈청PA수평현저저우병독조급대조조（여병독조상비，tCRP ＝10．68，tWBC ＝4．96，tPA ＝11．32；여대조조상비，tCRP ＝11．75，tWBC ＝5．37，tPA ＝12．08；균P＜0．05），치료후3조균무통계학차이（FCRP ＝1．75，FWBC ＝2．07，FPA ＝2．04；균P＞0．05）；치료후세균조혈청CRP、PA급WBC수평여치료전비교균유통계학차이（tCRP ＝9．478，tWBC ＝5．11，tPA ＝12．34；균P＜0．05）；이CRP≥8mg／L，WBC≥10×109／L，PA≤165mg／L위양성，감염성질병환인중CRP、WBC、PA세균조양성솔여병독조화대조조비교，차이균유통계학의의（여병독조비교χ2CRP ＝10．90，χ2WBC ＝4．13，χ2PA ＝20．63；여대조조비교χ2CRP ＝22．86，χ2WBC ＝7．60，χ2PA ＝28．68；균P＜0．05），병독조여대조조비교，차이균무통계학의의（χ2CRP ＝1．35，χ2WBC ＝0．73，χ2PA ＝0．63；균P＞0．05）。각조지표경상관성분석발현，CRP여WBC지간정현직선정상관（r＝0．56，P＜0．01），PA여CRP이급PA여WBC지간균정현부상관（r치분별위－0．51，0．23，균P＜0．01）。결론 CRP、PA급WBC연합검측대감염성질병환인진단치료구유중요림상의의，CRP、PA수평변화가작위반영인동세균감염민감지표。
Objective To investigate the clinical value of detection of C-reactive protein ( CRP) , prealbumin ( PA) , and white blood cell count ( WBC) levels in the diagnosis and treatment of infectious diseases in children.Methods A total of 72 children with infectious diseases treated in People’ s Hospital of Ruian City during the period of September 2011 to September 2013 were recruited in the study, including 36 cases with bacterial infection ( bacterial group ) and 36 cases with viral infection ( viral group ) .All patients were given symptomatic treatment.The levels of CRP, PA and WBC in serum before and after treatment were detected.Another 36 cases of healthy children were selected as control group.Results Before treatment, the levels of CRP and WBC in bacteria group were significantly higher than those in viral group and the control group, and the level of PA was significantly lower than that in viral group and the control group (compared with viral group:tCRP =10.68, tWBC =4.96, tPA =11.32, compared with the control group, tCRP =11.75, tWBC =5.37, tPA =12.08;all P<0.05).There was no significant difference in three groups after treatment (FCRP =1.75, FWBC =2.07, FPA =2.04, all P>0.05).After treatment the levels of CRP, PA and WBC had significant differences in bacteria group (tCRP =9.475, tWBC=5.11,tPA =12.34, all P<0.05).Taking CRP≥8mg/L, WBC≥10 109/L, PA≤165 mg/L as positive indices, the positive rates of CRP, WBC, PA in bacterial group were significantly different from viral group and the control group (compared with viral group:χ2 =10.89,χ2 =4.13,χ2 =20.63;compared with the control group:χ2 =22.86,χ2 =7.60,χ2 =28.68, all P<0.05).The difference was not statistically significant between viral group and the control group (χ2CRP=1.35,χ2WBC =0.73,χ2PA =0.63, all P<0.05).The correlation analysis showed that there was a linear positive correlation between CRP and WBC (r=0.56,P<0.01) and that PA was negatively correlated with CRP and WBC (r value was -0.51 and -0.23, respectively, both P<0.01).Conclusion Joint detection of CRP, PA and WBC has important clinical implications for diagnosis and treatment of infectious diseases in children.CRP and PA levels can be used as sensitive indicators of bacterial infection in children.