Value of procalcitonin combined with high-sensitivity C-reactive protein in the diagnosis and treatment of bronchopneumonia in children

Abstract

Objective To research the clinical application of procalcitonin (PCT) combined with high sensitivity C reactive protein (hs-CRP) in the diagnosis and treatment of bronchopneumonia in children. Methods From February 2016 to March 2017, seventy-nine cases of 2~6 years old children with bronchial pneumonia in Hainan Maternity and Child Health Care Hospital were selected as the observation group.According to the degree of infection, the patients were divided into the general infection group (46 cases) and the severe infection group (33 cases). At the same time, a total of 43 healthy children of the same age group who underwent physical examination at the physical examination center of the same hospital during the same period were selected as control group.The changes of PCT and hs-CRP levels among different groups were compared. Results Before treatment, the levels of PCT and hs-CRP in the observation group were (0.781±0.273) μg/L, (15.21±2.57) g/L, higher than those in the control group ((0.038±0.019)μg/L, (2.83±0.49) g/L), the difference of the two groups was statistically significant (t=17.789, 31.224, respectively, P=0.000). The PCT and hs-CRP levels of children in the general infection group were (0.673±0.186)μg/L, (12.78±2.52) g/L, which were significantly lower than those of the severe infection group ((1.235±0.287)μg/L, (18.54±3.67) g/L), and the differences were statistically significant (t=10.557, 8.275, P=0.000). After 7 days of treatment, the levels of PCT and hs-CRP in the general infection groups ((0.112±0.045)μg/L, (3.92±0.73) g/L) were still lower than those in the severe infection group ((0.171±0.062)μg/L, (5.21±1.08) g/L)), and the differences were statistically significant (t=4.970, 6.337, P=0.000). The levels of PCT and hs - CRP in general infection group and severe infection group were significantly lower than those before treatment ( t=19.882, 22.904, 20.816, 20.016, P=0.000). Before the treatment, the PCT and hs-CRP positive rates in general infection group and severe infection group were 67.39%, 60.87% and 90.91%, 87.88%.After treatment, the PCT, hs-CRP positive rates of general infection group and severe infection group were 10.87%, 23.91%, 30.03% and 48.48%.The positive rates of PCT and hs-CRP in the two groups after treatment were significantly lower than those before treatment, the differences were statistically significant (t=30.849, 12.863, 25.384, 11.803, P=0.000, 0.000, 0.000, 0.001). The positive rates of PCT and hs-CRP in the general infection group before and after treatment were all significantly lower than those in the severe infection group, the differences were statistically significant(χ2=6.040, 6.976, 4.717, 5.157, P=0.014, 0.008, 0.029, 0.023). Conclusion The levels of PCT and hs-CRP in children with bronchial pneumonia were significantly higher than those in healthy children of the same age.During the period of diagnosis and treatment, the changes of PCT and hs-CRP levels can be observed, so that the attending doctors can control their changes in time and play a guiding role in clinical treatment. Key words: Bronchopneumonia; children; procalcitonin; hypersensitivity C reactive protein