动态监测血清降钙素原对儿童社区获得性重度肺炎的临床意义

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1、授予单位代码10089学号或申请号13371HebeiMedicalUniversity硕士学位论文在职科学学位动态监测血清降钙素原对儿童社区获得性重度肺炎的临床意义学位申请人：魏红艳导师：张少丹教授专业：儿科学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组)的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文,第一署名为单位河北医科

2、大学，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则,承担相应法律责任。研究生签名师签章•二级学院领导盖章：‘xu•年jr月‘日河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果,除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写,文责自负。研究生签名34^导师签章：yiy年ir月日目录中文摘要··············································

3、································1英文摘要··············································································4研究论文动态监测血清降钙素原对儿童社区获得性重度肺炎的临床意义前言··············································································8对象与方法·························

4、············································7结果··············································································9附表·············································································12讨论·················································

5、····························14结论·············································································19参考文献·······································································19综述在儿童社区获得性肺炎中血清炎性标志物的应用·················23致谢··························

6、·························································28个人简历·············································································29中文摘要动态监测血清降钙素原对儿童社区获得性重度肺炎的临床意义摘要社区获得性肺炎（CAP）是儿童最常见疾病之一，也是导致儿童死亡的常见病之一。5岁以下儿童的肺炎发病率调查发现显著高于年长儿，年龄越小，发病率越高，且农村儿童发病率高于

7、城市发病率。回首剖析1985-2008之间有关文献发现5岁以下儿童肺炎病死率为180/10万～1200/10万人口，农村高于城市。目前，随着环境污染的加剧，肺炎的患病率正逐年上升。儿童，尤其是小婴儿，因其呼吸系统发育不完善，免疫力低下，喂养不当等因素容易出现重度肺炎，且儿童病情变化快，进展迅速，重度肺炎易出现并发症，如胸腔积液、心力衰竭、呼吸衰竭等，因此，死亡率较高。早期诊断及有效的治疗可以显著降低重度肺炎死亡率，除了患儿临床表现外，血清生物学标志物对其辅助诊断也提供了一个客观的依据。外周血白细胞在感染性疾病中

8、作为一种常用的炎性指标，在一定程度上对临床的诊断及治疗提供便利。但是白细胞计数的干扰素因素较多，在临床疾病诊断方面，敏感性及特异性有很大的局限性。C-反应蛋白（CRP）是一种急性应激蛋白，在肝脏中合成，CRP的高低和炎症反应、组织损伤程度直接相关。当机体急性反应时，出现时间早，随炎症反应进行持续性升高，但是在非感染性疾病中，CRP升高较早，持续时间长，不利于区分疾病的性质。降钙素原（P