Madhi Shabir A, Heera Jayvant R, Kuwanda Locadiah, Klugman Keith P
National Health Laboratory Service, University of The Witwatersrand, Johannesburg, South Africa.
PLoS Med. 2005 Feb;2(2):e38. doi: 10.1371/journal.pmed.0020038. Epub 2005 Feb 22.
Pneumonia remains the leading cause of death in young children. The poor specificity of chest radiographs (CXRs) to diagnose pneumococcal pneumonia may underestimate the efficacy of pneumococcal conjugate vaccine in preventing pneumococcal pneumonia.
The efficacy of nine-valent pneumococcal conjugate vaccine among children not infected with HIV (21%; 95% confidence interval, 1%-37%) increased when CXR-confirmed pneumonia was associated with serum C-reactive protein of 120 mg/l (12 mg/dl) or more and procalcitonin of 5.0 ng/ml or more (64%; 95% confidence interval, 23%-83%). Similar results were observed in children infected with HIV.
C-reactive protein and procalcitonin improve the specificity of CXR to diagnose pneumococcal pneumonia and may be useful for the future evaluation of the effectiveness of pneumococcal conjugate vaccine in preventing pneumococcal pneumonia.
肺炎仍然是幼儿死亡的主要原因。胸部X光片（CXR）诊断肺炎球菌肺炎的特异性较差，可能会低估肺炎球菌结合疫苗预防肺炎球菌肺炎的疗效。
当CXR确诊的肺炎与血清C反应蛋白≥120mg/L（12mg/dl）及降钙素原≥5.0ng/ml相关时，九价肺炎球菌结合疫苗在未感染HIV儿童中的疗效（21%；95%置信区间，1%-37%）有所提高（64%；95%置信区间，23%-83%）。在感染HIV的儿童中也观察到了类似结果。
C反应蛋白和降钙素原可提高CXR诊断肺炎球菌肺炎的特异性，可能有助于未来评估肺炎球菌结合疫苗预防肺炎球菌肺炎的有效性。
