超敏C反应蛋白对儿童急诊发热患儿重症感染情况的判定及预测
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摘要
目的分析超敏C反应蛋白对儿童急诊发热患儿重症感染情况的判定及预测应用价值。方法选取2016年11月~2017年11月我院收治的90例儿童急诊发热患儿作为研究组,根据感染情况将其分为重症感染组、局部感染组和非感染组,每组30例,另选取我院同期接受常规体检的30名健康儿童作为对照组。所有儿童均采用免疫散射比浊法检测超敏C反应蛋白,比较其检测结果,评价超敏C反应蛋白在儿童急诊发热患儿重症感染情况判定及预测中的应用价值。结果非感染组儿童的超敏C反应蛋白水平高于对照组,差异无统计学意义(P>0.05);重症感染组、局部感染组儿童的超敏C反应蛋白水平均显著高于对照组,差异有统计学意义(P<0.05);重症感染组、局部感染组儿童的超敏C反应蛋白水平均显著高于非感染组,差异有统计学意义(P<0.05);重症感染组的超敏C反应蛋白水平显著高于局部感染组,差异有统计学意义(P<0.05);非感染组、局部感染组、重症感染组的儿童超敏C反应蛋白水平<10、10~20 mg/L的构成比均明显低于对照组,且局部感染组、重症感染组>20 mg/L的构成比均高于对照组,差异有统计学意义(P<0.05)。局部感染组、重症感染组的儿童超敏C反应蛋白水平<10 mg/L的构成比均明显低于非感染组,局部感染组10~20 mg/L的构成比明显高于非感染组、重症感染组;局部感染组、重症感染组>20 mg/L的构成比均明显高于非感染组,差异有统计学意义(P<0.05)。重症感染组儿童超敏C反应蛋白水平<10、10~20 mg/L的构成比明显低于局部感染组,重症感染组>20 mg/L的构成比明显高于非感染组、局部感染组、差异有统计学意义(P<0.05);四组儿童超敏C反应蛋白阳性率的比较,差异均有统计学意义(P<0.05);治疗后,重症感染组、局部感染组、非感染组患儿的超敏C反应蛋白水平均明显低于治疗前,差异有统计学意义(P<0.05)。结论超敏C反应蛋白在儿童急诊发热患儿重症感染情况判定及预测中可发挥较高应用价值,随着患儿感染症状的加重,超敏C反应蛋白水平随之升高,且治疗后患儿的超敏C反应蛋白水平明显降低,提示超敏C反应蛋白可以作为儿童急诊发热患儿重症感染情况判定及预测的参照指标。
Objective To analyze the effectiveness of application of hypersensitive C-reactive protein(hs-CRP) in determination and prediction of severe infection of children with fever.Methods 90 children with acute fever admitted to our hospital from November 2016 to November 2017 were selected as the study group.According to the infection situation,they were divided into severe infection group,local infection group and non-infection group,30 cases in each group,and30 healthy children who underwent routine physical examination in our hospital during the same period were selected as the control group.All children were tested for hs-CRP by immunonephelometry,and the results were compared to evaluate the value of hs-CRP in the diagnosis and prediction of severe infection in children with acute fever.Results The level of hs-CRP in non-infected group was higher than that in control group(P>0.05).The levels of hs-CRP in severe infection group and local infection group were significantly higher than those in control group(P <0.05).The levels of hs-CRP in severe infection group and local infection group were significantly higher than those in non-infection group(P<0.05).The level of hs-CRP in severe infection group was significantly higher than that in local infection group(P<0.05).The hs-CRP levels of children in non-infection group,local infection group and severe infection group were significantly lower than those in control group(P<0.05),and the hs-CRP levels of children in local infection group and severe infection group were significantly higher than those in control group(P<0.05). The composition ratio of hs-CRP < 10 mg/l in local infection group and severe infection group was significantly lower than that in non-infection group,and the composition ratio of 10-20 mg/l in local infection group was significantly higher than that in non-infection group and severe infection group. The composition ratio of > 20 mg/l in local infection group and severe infection group was significantly higher than that in non-infection group(P <0.05). The hs-CRP levels of children in severe infection group were lower than those in local infection group(10 mg/l,10-20 mg/l),and those in severe infection group were higher than those in non-infection group and local infection group(P<0.05).The positive rates of hs-CRP in four groups were statistically significant(P<0.05).After treatment,the levels of hs-CRP in severe infection group,local infection group and non-infection group were significantly lower than those before treatment(P<0.05).Conclusion hs-CRP plays a higher application value in determination and prediction of severe infection of children with fever prediction.With the aggravation of infection symptoms in children,the level of hs-CRP increases and the post-treatment hs-CRP level significantly decreases,suggesting that hs-CRP can be used as a reference index for determination and prediction of severe infection in emergency fever children.
Objective To analyze the effectiveness of application of hypersensitive C-reactive protein(hs-CRP) in determination and prediction of severe infection of children with fever.Methods 90 children with acute fever admitted to our hospital from November 2016 to November 2017 were selected as the study group.According to the infection situation,they were divided into severe infection group,local infection group and non-infection group,30 cases in each group,and30 healthy children who underwent routine physical examination in our hospital during the same period were selected as the control group.All children were tested for hs-CRP by immunonephelometry,and the results were compared to evaluate the value of hs-CRP in the diagnosis and prediction of severe infection in children with acute fever.Results The level of hs-CRP in non-infected group was higher than that in control group(P>0.05).The levels of hs-CRP in severe infection group and local infection group were significantly higher than those in control group(P <0.05).The levels of hs-CRP in severe infection group and local infection group were significantly higher than those in non-infection group(P<0.05).The level of hs-CRP in severe infection group was significantly higher than that in local infection group(P<0.05).The hs-CRP levels of children in non-infection group,local infection group and severe infection group were significantly lower than those in control group(P<0.05),and the hs-CRP levels of children in local infection group and severe infection group were significantly higher than those in control group(P<0.05). The composition ratio of hs-CRP < 10 mg/l in local infection group and severe infection group was significantly lower than that in non-infection group,and the composition ratio of 10-20 mg/l in local infection group was significantly higher than that in non-infection group and severe infection group. The composition ratio of > 20 mg/l in local infection group and severe infection group was significantly higher than that in non-infection group(P <0.05). The hs-CRP levels of children in severe infection group were lower than those in local infection group(10 mg/l,10-20 mg/l),and those in severe infection group were higher than those in non-infection group and local infection group(P<0.05).The positive rates of hs-CRP in four groups were statistically significant(P<0.05).After treatment,the levels of hs-CRP in severe infection group,local infection group and non-infection group were significantly lower than those before treatment(P<0.05).Conclusion hs-CRP plays a higher application value in determination and prediction of severe infection of children with fever prediction.With the aggravation of infection symptoms in children,the level of hs-CRP increases and the post-treatment hs-CRP level significantly decreases,suggesting that hs-CRP can be used as a reference index for determination and prediction of severe infection in emergency fever children.
引文
[1]胡杨,刘春峰.SIRS标准及C-反应蛋白对儿科急诊发热患儿重症感染情况的判定及预测作用[J].中国小儿急救医学,2017,24(7):517-522.
[2]罗诚武,李深根,吴彩霞,等.血清降钙素原和超敏C反应蛋白检测对发热儿童早期鉴别诊断的应用价值[J].中国当代医药,2015,22(4):116-118.
[3]秦育滨,李妙娜,黄燕容,等.降钙素原联合超敏C反应蛋白、血常规白细胞检测对发热儿童早期鉴别诊断的应用价值[J].医学检验与临床,2017,28(2):235-237.
[4]王淑云,邓有敬,张华峰,等.炎性指标对儿童发热性疾病诊断临床评价[J].中华医院感染学杂志,2016,26(8):1877-1879.
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[6]张绮翎,赵青,霍淑芬.降钙素原及超敏C反应蛋白检测在早期新生儿感染的临床意义[J].中国医学装备,2015,6(4):68-71.
[7]潘莲丽,李晓春,储振宇.降钙素原治疗儿童重症感染抗生素降阶梯临床价值研究[J].中国实用儿科杂志,2015,25(6):456-460.
[8]赵秋剑,高海锋,乔正梅,等.超敏C反应蛋白检测在儿童细菌和支原体感染中的应用研究[J].国际检验医学杂志,2017,38(6):772-773.
[9]田爱存,尹彦姝,宋存红,等.白细胞计数、超敏C反应蛋白、降钙素原对病理性黄疸患儿感染的诊断价值[J].实用临床医药杂志,2016,20(9):174-175.
[10]邵民坤,周燕,杜坤,等.炎性指标联合检测在鉴别诊断新生儿感染中的临床评价[J].中华医院感染学杂志,2016,26(7):1639-1641.
[11]关小勇,蒋丽华,傅锦坚,等.超敏C反应蛋白检测在新生儿感染性疾病诊疗上的应用误区[J].中国妇幼保健,2016,31(6):1197-1198.
[12]罗贤生,黄海妹,王智明,等.降钙素原、超敏C反应蛋白、血沉和血清铁蛋白对恶性血液病患者发热的诊断价值[J].实用医院临床杂志,2013,10(6):40-42.
[13]陈梅,潘成明,宋海涛.198例发热患者血清超敏C反应蛋白与白细胞变化的相关性研究[J].检验医学与临床,2013,10(13):1733-1734.
[14]赵立杰,王翠霞,赵卓华,等.血清降钙素原和超敏C反应蛋白联合检测在急性冠脉综合症患者发热原因的鉴别诊断意义[J].临床合理用药杂志,2015,8(11):92-93.
[15]张延芳,郑秀峰,高佩增,等.儿童无明显感染灶急性发热常用检验指标应用的诊断分析[J].中华医院感染学杂志,2016,26(20):4730-4731.
[2]罗诚武,李深根,吴彩霞,等.血清降钙素原和超敏C反应蛋白检测对发热儿童早期鉴别诊断的应用价值[J].中国当代医药,2015,22(4):116-118.
[3]秦育滨,李妙娜,黄燕容,等.降钙素原联合超敏C反应蛋白、血常规白细胞检测对发热儿童早期鉴别诊断的应用价值[J].医学检验与临床,2017,28(2):235-237.
[4]王淑云,邓有敬,张华峰,等.炎性指标对儿童发热性疾病诊断临床评价[J].中华医院感染学杂志,2016,26(8):1877-1879.
[5]国伟婷,张风华,李蓉.超敏C反应蛋白联合降钙素原在新生儿重症感染的应用效果观察[J].中国医师杂志,2016,18(12):1855-1857.
[6]张绮翎,赵青,霍淑芬.降钙素原及超敏C反应蛋白检测在早期新生儿感染的临床意义[J].中国医学装备,2015,6(4):68-71.
[7]潘莲丽,李晓春,储振宇.降钙素原治疗儿童重症感染抗生素降阶梯临床价值研究[J].中国实用儿科杂志,2015,25(6):456-460.
[8]赵秋剑,高海锋,乔正梅,等.超敏C反应蛋白检测在儿童细菌和支原体感染中的应用研究[J].国际检验医学杂志,2017,38(6):772-773.
[9]田爱存,尹彦姝,宋存红,等.白细胞计数、超敏C反应蛋白、降钙素原对病理性黄疸患儿感染的诊断价值[J].实用临床医药杂志,2016,20(9):174-175.
[10]邵民坤,周燕,杜坤,等.炎性指标联合检测在鉴别诊断新生儿感染中的临床评价[J].中华医院感染学杂志,2016,26(7):1639-1641.
[11]关小勇,蒋丽华,傅锦坚,等.超敏C反应蛋白检测在新生儿感染性疾病诊疗上的应用误区[J].中国妇幼保健,2016,31(6):1197-1198.
[12]罗贤生,黄海妹,王智明,等.降钙素原、超敏C反应蛋白、血沉和血清铁蛋白对恶性血液病患者发热的诊断价值[J].实用医院临床杂志,2013,10(6):40-42.
[13]陈梅,潘成明,宋海涛.198例发热患者血清超敏C反应蛋白与白细胞变化的相关性研究[J].检验医学与临床,2013,10(13):1733-1734.
[14]赵立杰,王翠霞,赵卓华,等.血清降钙素原和超敏C反应蛋白联合检测在急性冠脉综合症患者发热原因的鉴别诊断意义[J].临床合理用药杂志,2015,8(11):92-93.
[15]张延芳,郑秀峰,高佩增,等.儿童无明显感染灶急性发热常用检验指标应用的诊断分析[J].中华医院感染学杂志,2016,26(20):4730-4731.