Changes And Clinical Significance Of Serum C-reactive Protein,Immunoglobulin And Complement In Children With Community-acquired Pneumonia

Objective :To investigate the changes of serum C-reactive protein(CRP),immunoglobulin and complement in children with Community-Acquired Pneumonia(CAP)in our hospital.To provide a reference for clinical prediction of the classification and assessment of the severity of ACP in children,so as to better guide clinical treatment.Methods:A retrospective analysis was performed on 164 children who were diagnosed with CAP and hospitalized in Huaihe Hospital of Henan University from September 2019 to December 2022 and successfully completed the test.The general data and serum data of the children were collected.According to the pathological characteristics of pneumonia,the patients were divided into lobar pneumonia group(69cases)and bronchopneumonia group(95 cases).According to the severity of pneumonia,the included cases were divided into mild group(115 cases)and severe group(49 cases)for large group analysis.Second,lobar pneumonia and bronchopneumonia were divided into mild group and severe group respectively for subgroup analysis.Compare the serum concentrations of C-reactive protein(CRP),immunoglobulin A(Ig A),immunoglobulin G(Ig G),immunoglobulin M(Ig M),complement C3,and complement C4 in different groups.The data were statistically analyzed using SPSS 26.0 software,with P<0.05 indicating statistical difference.Results:1.A total of 164 children with CAP were enrolled in this study,aged from 3 months to 14 years,with an average age of 4.0(3.0,7.0)years.There were 84 boys(51.2%)and 80 girls(48.8%).69 cases(42.1%)were 0-3 years old,56 cases(34.1%)were 3-7 years old,13 cases(7.9%)were 7-10 years old,26 cases(15.9%)were 10-14 years old.There were 69 cases(42.1%)of lobar pneumonia,including 30 boys and 39 girls,aged from 1 to 13 years,with an average age of 5.0(3.0,8.0)years.95 cases(57.9%)had bronchopneumonia,including 54 boys and 41 girls,aged from 3 months to 14 years,with an average age of4.0(3.0,7.0)years.There was no significant difference in the average age of onset and the incidence of different age groups between the two groups.There were 115 mild cases(70.1%),including 57 boys and 58 girls,aged from 3 months to 14 years,of which the incidence was 48.7% in infants and 31.3% in preschool children,and 49 severe cases(29.9%),including 27 boys and 22 girls,aged from 6 months to 14 years,of which the incidence was 26.5% in infants and young children.There were significant differences in the average age of onset and the incidence of different age groups between the two groups.Severe pneumonia mainly occurred in infants(P < 0.05).There was no significant difference in gender composition between different groups.2.The serum indexes of the two pathological types of pneumonia groups were compared and analyzed.The results showed that the serum CRP,Ig G,Ig M and complement C3 in the lobar pneumonia group were higher than those in the bronchopneumonia group,and the difference was statistically significant(P < 0.05).There was no significant difference in Ig A and complement C4 between the two groups.3.The serum CRP value of the mild group was significantly lower than that of the severe group,and the serum Ig G,Ig A and complement C3 levels were higher than those of the severe group,the differences between the two groups were statistically significant(P < 0.05).However,there was no significant difference in serum complement C4 level between the two groups.4.The comparison between the mild and severe groups with different pathological types of pneumonia:in the children with lobar pneumonia,the serum CRP,Ig G and Ig M in the severe group were higher than those in the mild group,while Ig A and complement C3 were lower than those in the mild group,and the differences were statistically significant(P < 0.05).However,there was no significant difference in complement C4 between the two groups.In children with bronchopneumonia,the severe group had a significantly higher serum CRP level and significantly lower levels of Ig G,Ig A,and C3 than the mild group(P < 0.05).There was no significant difference in serum Ig M and complement C4 between the two groups.Conclusions:1.The incidence of different pathological types of community-acquired pneumonia is not related to age and gender,but the severity of community-acquired pneumonia is related to age.and Infants are more likely to develop into severe pneumonia.2.The serum CRP level is related to the type and severity of pneumonia in children.The higher the CRP level,the more likely it is to be lobar pneumonia and severe pneumonia.3.The disorder of serum immunoglobulin and complement C3 levels was more obvious in lobar pneumonia and severe pneumonia.