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目的 探讨肺炎患儿血糖、C反应蛋白 (CRP)、血气在全身炎症反应综合征 (SIRS)中的改变及其意义。方法 选择 72例肺炎合并SIRS患儿测定血气和动态测定血糖及CRP ,同时选择非SIRS的肺炎患儿和正常儿童作对照。结果 非SIRS组血糖与正常对照组比较差异无显著性 (P >0 .0 5 ) ,而CRP显著高于正常对照组 (t=3 .2 74,P <0 .0 0 1)。SIRS组与非SIRS组血气 ( pH、PaCO2 、PaO2 )比较差异无显著性 (P >0 .0 5 ) ,SIRS组血糖和CRP均显著高于非SIRS组(t =9.9498,P <0 .0 0 1) ,具有SIRS诊断标准 3项以上的患儿 48h血糖和第 5天CRP持续不降 (t=139.6 7,P <0 .0 1) ,发生多器官功能不全综合征 (MODS)率明显增高 ( χ2 =5 .15 2 ,P <0 .0 0 1)。结论 肺炎时血糖和CRP联合检测有助于准确评估SIRS病情的危重度 ,血糖和CRP持续性升高 ,预示着MODS的可能发生。
Objective To investigate the changes and significance of blood glucose, C-reactive protein (CRP) and blood gas in systemic inflammatory response syndrome (SIRS) in children with pneumonia. Methods Seventy-two children with pneumonia complicated with SIRS were selected for the determination of blood gas and blood glucose and CRP. Meanwhile, children with non-SIRS pneumonia and normal children were selected as controls. Results There was no significant difference in blood glucose between non-SIRS group and normal control group (P> 0.05), but CRP was significantly higher than that of normal control group (t = 3.224, P <0.01). There was no significant difference in blood gas (PaCO2, PaO2) between SIRS group and non-SIRS group (P> 0.05), and blood sugar and CRP in SIRS group were significantly higher than those in non-SIRS group (t = 9.9498, (P <0.01). The incidence of multiple organ dysfunction syndrome (MODS) was significantly higher in patients with more than three items of SIRS diagnostic criteria (P <0.01) (Χ2 = 5 .15 2, P <0. 0 0 1). Conclusions The combined detection of blood glucose and CRP in pneumonia can help to accurately assess the severity of SIRS and the persistent increase of blood glucose and CRP, indicating the possible occurrence of MODS.