hs-CRP与血细胞参数在新生儿感染中的诊断价值  

Diagnostic Value of Serum High Sensitivity C-reactive Protein(hs-CRP) and Haematological Parameters in Neonatal Infection Diseases

作　　者：佘尚扬[1] 李小妹[1] 韦秋芬[2] 胡雪桦[1] 周春浪[1] 闫芳[1] 唐玉群[1] 曾尚娟[1] 李颖丰[1] 

机构地区：[1]广西壮族自治区妇幼保健院检验科,530003 [2]广西壮族自治区妇幼保健院新生儿科,530003

出　　处：《放射免疫学杂志》2011年第4期439-442,共4页Journal of Radioimmanology

基　　金：广西壮族自治区卫生厅自筹经费课题(Z2008201)

摘　　要：目的:评估hs-CRP与血细胞参数(WBC、GR%、PLT)在新生儿感染中的诊断价值。方法:分别检测败血症组患儿(49例),肺炎组患儿(37例)治疗前、治疗(3～5)d、治疗(7～10)d后hs-CRP、WBC、GR%、PLT各参数值,以100例健康儿为对照组。结果:治疗前,hs-CRP组间比较均有显著差异(P<0.05);WBC对照组与疾病组均有显著性差异(P<0.05),疾病组间无差异,(P>0.05);GR%败血症组与肺炎组、对照组均有差异(P<0.05),肺炎组与对照组无差异(P>0.05);PLT三组间均无显著性差异(P>0.05)。绘制疾病组各参数随治疗时间变化曲线,hs-CRP、WBC、GR%随治疗呈下降趋势,以败血症组hs-CRP表现明显,PLT随治疗呈上升趋势。应用ROC曲线求各参数对疾病诊断的敏感性、特异性、阳性预测值、阴性预测值,以败血症组hs-CRP诊断价值最高(敏感性79.6%、特异性74.0%、阳性预测值75.4%、阴性预测值78.4),败血症组WBC、GR%、PLT评估值略高于肺炎组,但敏感性、特异性、阳性预测值、阴性预测值均低于68%。结论:hs-CRP可作为新生儿败血症的早期诊断指标,但低值不能排除新生儿败血症;hs-CRP作为新生儿肺炎早期诊断指标存在一定局限性;WBC、GR%、PLT作为新生儿败血症及肺炎早期诊断指标具有局限性;hs-CRP、WBC、GR%、PLT均可应用于新生儿败血症及肺炎疗效观察中。Objective To evaluate the diagnostic value of serum high sensitivity C-reactive protein（hs-CRP） and haematological parameters,including white blood cell（WBC）,platelet（PLT） and percentage of neutrophil granulocyte（GR%） in neonatal infection diseases.Methods Serum hs-CRP levels and haematological parameters were determined in neonatal sepsis group（49 cases） and neonatal pneumonia group（37 cases） at pre-treatment,3~5 day post-treatment and 7~10 day post-treatment respectively.100 health individuals were used as control group.Results At pre-treatment,hs-CRP levels were significant different among different groups（P0.05）;WBC levels were different between patient groups and control group（P0.05） but no real difference between two patient groups（P0.05）;For GR%,neonatal sepsis group had difference with control group（P0.05） but no difference with neonatal pneumonia group（P0.05）;The levels of PLT had no significant differences between all three groups（P0.05）.In the parameter curves with different treatment time points,it was shown hs-CRP,WBC and GR% had decreasing tendency with treatment,and hs-CRP in neonatal sepsis group was the most significant;meanwhile,PLT had increasing tendency.By using ROC curve to evaluate sensitivity,specificity,positive predictive value and negative predictive value in diagnosis,it was found hs-CRP in neonatal sepsis group had the best value.The value of WBC,GR% and PLT in neonatal sepsis group were better than those in neonatal pneumonia group but their sensitivity,specificity,positive predictive value and negative predictive value were all below 68%.Conclusion hs-CRP could be used as early diagnosis marker for neonatal sepsis disease but not for neonatal pneumonia disease.WBC,GR%,PLT have some limitations if used as early diagnosis markers in both of neonatal sepsis and pneumonia diseases.Furthermore,hs-CRP,WBC,GR% and PLT all could be applied in the evaluation of theraputic effects for neonatal sepsis and pneumonia diseases.

关 键 词：感染性疾病 C-反应蛋白 血细胞参数 诊断价值 

分 类 号：R541.4[医药卫生—心血管疾病]