探讨发热患儿血清降钙素原(PCT)及C－反应蛋白(CRP)水平在儿童发热性疾病中的临床意义。

选择2009年10月至2010年10月在本院住院的176例发热患儿为研究对象。采用回顾性分析方法，根据出院时的诊断结果，将其分为细菌感染组(包括病毒及支原体，n＝79)、非细菌感染组(n＝71)和风湿性疾病组(n＝26)。同时，将同期在本院体检的自愿参加本研究的健康儿童纳入对照组(n＝35)。3组受试儿童的血清CRP及PCT检测水平，与对照组健康儿童进行统计学比较(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象监护人的知情同意，并与之签署临床研究知情同意书)。4组受试儿童年龄、性别、入院时热程、营养状况及合并其他疾病等比较，差异无统计学意义(P>0.05)。

细菌感染组、非细菌感染组、风湿性疾病组及对照组患儿CRP值分别为(24.34±4.21)mg/L，(1.32±0.04)mg/L，(101.31±15.20)mg/L和(1.29±0.03)mg/L；细菌感染组、非细菌感染组、风湿性疾病组及对照组患儿PCT值分别为(4.17±0.92)μg/L，(0.06±0.01)μg/L，(0.70±0.11 )μg/L和(0.08±0.02)μg/L 。细菌感染组CRP及PCT值与对照组比较，均明显升高，组间比较，差异有统计学意义(P<0.01)；非细菌感染组与对照组比较，则无明显变化，差异无统计学意义(P>0.05)。风湿性疾病组CRP值较对照组升高极为显著，差异有统计学意义(P<0.001)；而PCT值仅轻度升高，与对照组比较，差异无统计学意义(P>0.05)。

CRP及PCT联合检测在儿童发热性疾病的鉴别诊断中，具有重要意义。

To detect the clinical value of the levels of serum procalcitonin (PCT) and C-reactive protein(CRP)in children with febrile disease.

From October 2009 to October 2010, clinical data of 174 children suffered from febrile disease were recruited. According to their discharge diagnosis, they were divided into bacteria infect disease group(n=79), non-bacteria infect disease group (n=71) and rheumatic disease group(n=26). Meanwhile, another 40 cases of healthy children were recruited into control group(n=35). PCT and CRP levels were detected in all cases including thirty-five healthy control cases. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Fujian Provincial Hospital of Fujian Medical University. Informed consent was obtained from the parents of each participating child. There had no significance difference between four groups among gender, age, and complicating other diseases (P>0.05). Retrospective analytical method were conducted on the levels of CRP and PCT among four groups.

The levels of CRP in bacteria infection disease group, non-bacteria infection disease group, rheumatic disease group and control group were (24.34±4.21) mg/L, (1.32±0.04) mg/L, (101.31±15.20) mg/L and (1.29± 0.03) mg/L, respectively. And the levels of PCT were (4.17±0.92)μg/L, (0.06±0.01)μg/L, (0.70±0.11)μg/L and (0.08±0.02)μg/L, respectively. Levels of PCT and CRP were dramatically higher in bacteria infection diseases group (P<0.01). And there were no significant difference in the levels of PCT and CRP between non-bacteria infection diseases group and control group. In rheumatic disease group, the level of CRP was much higher than that in control group (P<0.001), and the level of PCT increased a little with no significant difference compared with that in control group (P<0.05).

The measurement for the levels of serum CRP and PCT might be a valuable indicator in the diagnosis of febrile disease in children.