| Objectives:To monitor the level of serum C-reactive protein (CRP), procalcitonin (PCT), prealbumin (PA) and white blood cell (WBC) in the children with bacterial pneumonia of before and after antibiotic treatment, in order to learn more about the guiding role of CRP, PCT, PA and WBC for diagnosing bacterial pneumonia, assessment of the pneumonia status and treatment in children patients. And also to discuss the correlation between the laboratory markers including CRP, PCT, PA, WBC and the happenings of childhood bacterial pneumonia.Methods:Ninety-six aged from one month to six years old children with bacterial pneumonia form in-hospital patients of pediatrics in the people’s hospital of Guangxi zhuang autonomous region during June 2013 to December 2014 were included in the study. All patient hospital clinical data were collected. The levels of CRP, PCT, PA and WBC before and after antibiotic treatment in children with bacterial pneumonia was detected by using immunofluorescence dry quantitative method, electrochemical luminescence method, project the immune turbidimetry and white blood cell count method respectively. The results of inflammatory markers including CRP, PCT, PA and WBC would compared with that of the control group who are forty-three healthy children aged from one month to six years old.Results:1. Serum infection markers1.1 Changes of the infection markers in pneumonia group and control group. The concentration of serum infection markers in pneumonia group before the antibiotic treatment and control group children were following respectively. CRP was 12.14±6.36mg/L and 6.82±3.86mg/L; PCT was 0.18±0.15ng/ml and 0.047±0.030ng/ml; WBC was (14.01±8.5) ×109/L and (10.46±4.6) ×109/L; PA was 120.29±50mg/L and 154.51±46.94mg/L; Comparing to the levels between pneumonia group and control group, there were statistical significance (p<0.05)1.2 Changes of the infection markers in pneumonia group before and after the treatment. The levels of serum infection markers in pneumonia group before and after antibiotic treatment were following respectively. CRP was 13.20 ±7.01mg/L and 6.90±4.17mg/L; PCT was 0.17±0.13ng/ml and 0.08±0.04ng/ml; WBC was (14.01±8.5) ×109/L and (9.68±4.37)×109/L; PA was 121.11± 45.88mg/L and 194.75±64.51mg/L; there were statistical significance (p<0.05) between before and after treatment.2. Sensitivity and specificity of infection markers in different critical value2.1 The sensitivity and specificity of CRP. The concentration of CRP being used less to 5mg/L,5-10mg/L,10-15mg/L,15-20mg/L, more than 20mg/L separately would expressed respectively normal, almost normal, suspicious, roughly suspicious and absolute suspicious as the critical value of bacterial infection. The sensitivity and specificity were 84.38%,58.33%,35.42%,12.5%,0.00% and 74.42%,88.37%,93.02%,100%,100% respectively. The ROC curve area was 0.824.2.2 The sensitivity and specificity of PCT. The concentration of PCT being separately used less to 0.05ng/ml,0.05-0. 10ng/ml,0.10-0.15ng/ml,0.15-0.20 ng/ml, more than 0.20ng/ml expressed respectively normal, almost normal, suspicious, roughly suspicious and absolute suspicious as the critical value of bacterial infection. The sensitivity and specificity were 97.92%,67.71%, 46.88%,30.21%,0.00% and 83.72%,97.67%,97.67%,97.67%,100% respectively. The ROC curve area was 0.948.2.3 The sensitivity and specificity of WBC. The count results of WBC being separately used(4-10)×109/L,10-12)×109/L,(12-15)×109/L,(15-20) ×109/L, more than 20 ×109/L expressed respectively normal, almost normal, suspicious, roughly suspicious and absolute suspicious the critical value of bacterial infection. The sensitivity and specificity were 66.67%,47.92%,30.21%, 17.71%,0.00% and 53.49%,67.44%,88.40%,95.35%,100% respectively. The ROC curve area was 0.628.Conclusion:1. The levels of CRP, PCT and WBC were higher in infection period in the children with bacterial pneumonia than that of the control group. Which could decline and even normal after antibiotic treatment. PA level was lower and after treatment can up to the normal.2. The sensitivity and specificity of PCT to speculate bacterial infection for childhood pneumonia were higher than the other serum infection markers, including CRP and WBC, which likely to be priority as pre-screening testing indicator for diagnosis of bacterial infection.3. There could be meaningful to improve the reliability of bacterial pneumonia diagnosis by analysis all serum infection markers including CRP, PCT and WBC. |
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