目的 探讨D-二聚体(DD)、降钙素原(PCT) 及C-反应蛋白(CRP)水平在小儿支原体肺炎合并胸腔积液诊断及预后判断中的作用。方法 收集58例支原体肺炎合并胸腔积液患儿的临床资料,回顾性分析患儿的一般性特征,对发病期、恢复期及健康对照组进行DD 、PCT、CRP的检测,分析DD、PCT、CRP升高与患者发病期及预后的相关性对大量积液组、中量积液组、少量积液组患儿进行以及胸水常规化验指标分析比较。结果 发病期DD、PCT和CRP均高于恢复期、健康对照组(P均<0.01);恢复期DD高于对照组(P<0.01),PCT水平与对照组差异无统计学意义(P>0.05),CRP水平与对照组相比差异不大(P=0.015);发病期患儿体内DD、PCT及CRP升高的比例明显高于恢复期水平;发病期患儿大量积液组DD、PCT、CRP、有核细胞数、TP、LDH、ADA水平明显高于中等积液组、少量积液组;发病期CRP与DD、PCT升高呈正相关。结论 DD、PCT及CRP升高可以反映患儿支原体肺炎合并胸腔积液严重程度以及积液量;DD、PCT及CRP的变化趋势可以反映预后。

Objective To investigate the role of D-dimer (DD),procalcitonin (PCT) and C-reactive protein (CRP) levels in diagnosis and prognosis in children with mycoplasma pneumonia (MP) combined with pleural effusion. Methods The clinical data of 58 children with MP combined with pleural effusion were collected.The general characteristics of patients were analyzed retrospectively.The levels of DD,PCT and CRP among onset period group,recovery period group and healthy control group were detected.The levels of DD,PCT,CRP and conventional detection index of pleural effusion among different groups of pleural effusion quantity were detected,and the correlation between increased levels of DD,PCT and CRP and prognosis were analyzed. Results The levels of DD,PCT and CRP of onset period group were higher than those of the recovery period group and control group,and the differences were statistically significant (P<0.01);The levels of DD in recovery period group was higher than in control group (P<0.01).PCT levels had no significant difference between recovery period group and control group (P> 0.05),and the increased levels of CRP in recovery period group was insignificant compared to control group (P=0.015);The proportion of elevated levels of DD,PCT and CRP in onset period group were significantly higher than those of recovery period group;The levels of DD,PCT,CRP,TP,LDH,ADA and WBC with children in large volume pleural effusion were significantly higher than those in small amount pleural effusion and middle volume pleural effusion group,and the level of CRP was positively correlated with DD and PCT in recovery period group. Conclusion The increased levels of DD,PCT and CRP may reflect the severity and prognosis of mycoplasma pneumonia combined with pleural effusion.