摘要
目的探讨C反应蛋白（CRP）在2~12岁急性中耳炎患儿血清中的表达,将CRP作为中耳炎诊治中抗生素使用的有力佐证.方法选择急性中耳炎患儿250例作为研究对象,除有52例拒做检测外,余均经过CRP检测的198例患儿（231只耳）入组.治疗前全部患儿均检查CRP,治疗后随访1个月,于治疗后3 d、1周及1个月分别复查CRP并评估疗效.根据单双号将患儿随机分为全身使用抗生素组（A组）和非使用全身抗生素组,双号中再将患儿分为外用抗生素组（B组）和观察疗法组（C组）,比较三组间CRP水平变化.结果198例（231耳）中,治疗后3 d时痊愈71耳,好转33耳,无效127耳,有效率为45.0%（104/231）;1周时痊愈100耳,好转45耳,无效86耳,有效率为62.8%（145/231）;治疗后1个月时痊愈121耳,好转56耳,无效54耳,有效率为76.6%（177/231）.三个时间点的疗效差异均有统计学意义（x2=14.643、48.406,10.494,均P〈0.05）.198例患儿中,CRP低表达组188耳,CRP高表达组43耳;经治疗3 d后,B组＋C组CRP高表达率显著降低（x2=5.979,P=0.014）,A组降低更明显（x2=13.948,P=0.000）.结论监测CRP可以指导抗生素的使用.
Objective To analyze the expression of C-reactive protein（CRP）in 2-12-year-old children with acute otitis media（AOM）,we can use CRP as a strong evidence for the usage of antibiotics in the diagnosis and treatment of otitis media.Methods 250 children with AOM were selected as the research subjects.52 cases refused to test,CRP was detected in 198 children（231 ears）.CRP was examined in all patients before treatment,they were followed up for 1 month.After treatment,CRP was reviewed in three days,one week and one month,respectively.Results In 198 children（231 ears）,71 ears were recovered,33 ears improved,and 127 ears were ineffective in three days,the effective rate was 45.0%（104/231）.100 ears were recovered,45 ears improved,and 86 ears were ineffective in one week,the effective rate was 62.8%（145/231）.121 ears were recovered,56 ears improved,and 54 ears were ineffective in one month,the effective rate was 76.6%（177/231）.The effective rate were significantly different among the three groops（x2=14.643、48.406,10.494,all P〈0.05）.Among 198 children,188 ears were in the low expression group,43 ears were in the high expression group.After three days of treatment,the composition ratio of group B and group C was changed（x2 =5.979,P=0.014）,while group A had a significant change（x2 =13.948,P=0.000）.Therefore,early use of antibiotics was effective in reducing CRP,so as to reduce the clinical symptoms in children.Conclusion CRP can be used to guide antibiotic monitoring.
出处
《中国基层医药》
CAS
2017年第16期2524-2527,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
C反应蛋白
中耳炎
儿童
C-reactive protein
Otitis media
Child
