小儿肺炎合并SIRS时血糖、CRP及PLT的改变及意义

目的 :探讨肺炎患儿 C反应蛋白 (CRP)、血小板计数 (PL T)和血糖在全身炎症反应综合征 (SIRS)中的改变及其意义。方法 :动态测定 58例肺炎合并 SIRS患儿 (SIRS组 )的 CRP、PL T和血糖 ,同时与非 SIRS的肺炎患儿 (非 SIRS组 )和正常儿童 (对照组 )作对照。结果 :非 SIRS组的血糖、PLT与对照组比较差异无显著性 (P>0 .0 5) ,而 CRP水平显著高于对照组 (P<0 .0 5) ;SIRS组血糖、CRP均显著高于非 SIRS组 (P<0 .0 1 ) ,PL T显著低于非 SIRS组 (P<0 .0 1 )。符合诊断标准 3项以上的患儿 48h血糖和第 5天 CRP持续不降 ,72 h PL T明显下降 ,多器官功能不全综合征 (MODS)发生率明显增高。结论 :联合检测肺炎患儿的血糖、CRP和 PL T计数有助于准确评估病情的危重度 ,血糖、CRP持续性升高、PLT持续下降 ,预示有发生 MODS的可能。

Changes of blood glucose,C-reactive protein and platelet count in children with pneumonia and systemic inflammatory respose syndrome

Objective:To observe the changes of blood glucose,C-reactive protein(CRP)and platelet count(PLT)in patients with pneumonia and systemic inflammatory response syndrome(SIRS).Methods:Dynamic changes of blood glucose,CRP and PLT were detected in 58 pneumonic children with SIRS,68 without SIRS and 30 healthy controls.Resulte:Only CRP levels in patients without SIRS were superior to those in control group(P<0.05).Compared with patients without SIRS,blood glucose and CRP were increased and PLT was decreased significantly in SIRS group(P<0.01).Among children with 3 items of diagnostic standard for SIRS,there were no decrease of blood glucose on day 2 and of CRP on day 5,and an obvious decrease of PLT on day 3,and there existed an increased incidence of multiple organ dysfunction syndrome(MODS).Counclusion:Simultaneous detection of blood glucose,CRP and PLT is helpful in evaluating the severity of SIRS.The continuous increase of blood glucose and CRP,and the decrease of PLT could predict the occurrence of MODS.