Peltola Ville, Toikka Pia, Irjala Kerttu, Mertsola Jussi, Ruuskanen Olli
Department of Pediatrics, Turku University Hospital, Turku, Finland.
Scand J Infect Dis. 2007;39(6-7):560-5. doi: 10.1080/00365540601158722.
Total white blood cell (WBC) counts and serum C-reactive protein (CRP) are used as inflammatory markers in febrile children. We studied the occurrence and clinical significance of discrepancy in these markers. From a 2-y period, we retrospectively reviewed the medical records of febrile children (> or =1 month of age) with WBC > or =15 x 10(9)/l and/or CRP levels > or =80 mg/l, as well as of children with lower values in both these parameters. WBC and CRP were discordant in 556 children and concordantly high in 194 children. A severe bacterial disease was presumed in 57% of children with concordantly high WBC and CRP, in 20% of those with discordant values, and in 5% of those with low levels of these markers (p<0.001). Non-streptococcal tonsillitis was the most common viral infection associated with elevated WBC and CRP. In conclusion, WBC and CRP are commonly discrepant in febrile children. Measuring both markers increases substantially the detection rate of bacterial infections.
全血细胞计数（WBC）和血清C反应蛋白（CRP）被用作发热儿童的炎症标志物。我们研究了这些标志物出现差异的情况及其临床意义。在为期2年的时间里，我们回顾性分析了WBC≥15×10⁹/L和/或CRP水平≥80mg/L的发热儿童（年龄≥1个月）以及这两个参数值较低的儿童的病历。556名儿童的WBC和CRP不一致，194名儿童的WBC和CRP均显著升高。WBC和CRP均显著升高的儿童中，57%被推测患有严重细菌性疾病；WBC和CRP不一致的儿童中，20%被推测患有严重细菌性疾病；这两种标志物水平较低的儿童中，5%被推测患有严重细菌性疾病（p<0.001）。非链球菌性扁桃体炎是与WBC和CRP升高相关的最常见病毒感染。总之，发热儿童中WBC和CRP通常不一致。同时检测这两种标志物可大幅提高细菌感染的检出率。
