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目的:分析多种实验室手段的综合应用在小儿支原体肺炎早期诊断中的临床价值,为临床早期诊断支原体肺炎开发新的思路。方法:选择2014年9月至2015年8月我院收治的肺炎支原体患儿共计60例作为观察组;另外选择同期非支原体肺炎小儿95例作为对照组,其中对照1组为细菌性肺炎55例,对照2组为病毒性肺炎40例。回顾性分析3组小儿高敏C-反应蛋白、降钙素原及MP-IgM水平,同时分析总结观察组患儿胸部X线检查结果。结果:入院时观察组患儿血清高敏感C-反应蛋白、降钙素原水平分别为(11.08±3.53)mg·L~(-1)、(1.01±0.66)ng·L~(-1),对照组(1、2)患儿血清中高敏C-反应蛋白水平分别为(18.13±6.09)mg·L~(-1)、(5.55±2.62)mg·L~(-1),降钙素原水平分别为(1.50±0.95)ng·L-1、(0.36±0.14)ng·L~(-1),3组相比,差异具有统计学意义(P<0.05)。观察组患儿胸部X线检查结果显示,双肺纹理增粗者占8%、呈大叶性肺实变者占30%、呈小叶性肺浸润者占37%、呈肺门影增大者占17%、胸腔积液者占7%、未见明显异常者占2%。结论:对于临床诊断肺炎的小儿,早期可通过血清中高敏C-反应蛋白、降钙素原、MpIgM水平及胸部X线检查对其进行综合分析,对支原体感染作出早期预诊。对于高度怀疑者可早期给予阿奇霉素治疗,Mp-IgM水平早期阳性率不高,但早期结果可通过与复查时相比或比较两次定性值的变化来早期判断支原体肺炎的感染。
Objective: To analyze the clinical value of comprehensive application of multiple laboratory instruments in the early diagnosis of mycoplasma pneumonia in children and to develop new ideas for the early diagnosis of mycoplasma pneumonia. Methods: From September 2014 to August 2015, 60 children with Mycoplasma pneumoniae admitted to our hospital were selected as the observation group. 95 children with non-mycoplasmal pneumonia in the same period were selected as the control group, and 55 in the control group 1 were bacterial pneumonia , Control group 2 was viral pneumonia in 40 cases. Retrospective analysis of three groups of children with high-sensitivity C-reactive protein, procalcitonin and MP-IgM levels, while analysis of the observation group of children with chest X-ray findings. Results: The levels of serum high sensitive C-reactive protein and procalcitonin in the observation group were (11.08 ± 3.53) mg · L -1, (1.01 ± 0.66) ng · L -1, (18.13 ± 6.09) mg · L ~ (-1), (5.55 ± 2.62) mg · L ~ (-1) respectively in the control group (1, 2) (1.50 ± 0.95) ng · L-1, (0.36 ± 0.14) ng · L -1, respectively. The difference between the three groups was statistically significant (P <0.05). The results of chest X-ray examination in the observation group showed that 8% of patients with thickening of lungs, 30% of patients with lobar lung consolidation, 37% of patients with lobular lung invasion, Accounting for 17%, pleural effusion accounted for 7%, no significant abnormalities accounted for 2%. CONCLUSIONS: For children with clinically diagnosed pneumonia, early detection of mycoplasma infection can be performed early by comprehensive analysis of serum high-sensitivity C-reactive protein, procalcitonin, MpIgM levels and chest X-ray findings. Early azithromycin treatment for highly skeptical, Mp-IgM early positive rate is not high, but the early results can be compared with the review or compared to two qualitative changes in the early determination of mycoplasma pneumonia infection.