不同败血症高危因素对新生儿血清降钙素原影响的分析  

Serum procalcitionin concentration in neonates with risk factors associated with sepsis:a clinical analysis

作　　者：许蔓春[1] 马恒颢[1] 欧巧群[1] 任广立[1] 彭智勇[1] 欧春泉[2] 朱会英[3] 

机构地区：[1]中国人民解放军广州军区广州总医院小儿科,广州510010 [2]南方医科大学公共卫生与热带医学学院生物统计学系,广州510515 [3]中国人民解放军广州军区广州总医院感染控制科,广州510010

出　　处：《国际检验医学杂志》2011年第15期1710-1711,1713,共3页International Journal of Laboratory Medicine

摘　　要：目的分析不同败血症高危因素对新生儿血清降钙素原（PCT）水平的影响。方法随机选择181例住院新生儿，包括足月儿121例和早产儿60例。根据有无败血症及其高危因素，将足月儿分为：足月对照组、足月败血症高危因素组、足月非败血症高危因素组、足月败血症组。其中足月败血症高危因素组又分为足月宫内窘迫／术后窒息组和足月胎膜早破（PROM）组，后者按PROM不同时间分为大于18h组、〉12～18h组和0～12h组。早产儿也按相同标准分组。分别检测各组PCT、水平并进行统计学分析。结果足月宫内窘迫／术后窒息组与足月非败血症高危因素组比较，PCT水平差异无统计学意义（P=0．05）；〉18h组PCT水平明显增高，但与足月败血症组比较无统计学意义差异（P〉0．05）。早产儿各组的组间比较结果与足月儿类似。相比于C反应蛋白（CRP），败血症高危因素新生儿PCT水平的动态变化与临床情况更一致（P〈0．01）。结论不同败血症高危因素对新生儿PCT水平有不同的影响，结合PCT水平的动态监测，能为临床合理使用抗菌药物提供重要依据。Objective To analysis the serum procalcitionin（PCT） concentration in neonates with risk factors associated with sepsis. Methods The serum concentration of PCT were measured in 181 hospitalized neonates including 121 term newborns and 60 preterm newborns with gestationai age 32--37 weeks. Termborns assigned different groups according to the diagnostic criteria of septicemia and its＇ risk factors：the group with risk factors associated with sepsis including the intrauterine distress/asphyxia group and the three premature rupture of membranes （PROM） groups （the duration of PROM〉 18 h, 〉 12- 18 h, 0- 12 h ）, the septice mid group,the non-infection disease group,the contrast group, and preterm newborns were assigned their groups according to the same criteria. The data obtained were subjected to statistical analysis designed. Results The PCT level in the termborns with intra- uterine distress/asphyxia group was no significantly difference comparing with the nominfection group （P〉 0.05）, the PCT level （〉0.5 μg/L） was significantly higher in the PROM〉18 h group as the same with that in the septicemia group,and on significantly difference between two groups, the similar results of was exist in premature newborns. Compared with classic CRP,dynamic change of PCT was more better correlation with clinical change of infection in the neonates with risk factors of sepsis （P〈0. 01 ）. Conclusion Serum PCT concentration are different in neonates with risk factors associated with sepsis, and dynamic detection of PCT can be helpful to the rational use of antibiotics.

关 键 词：婴儿 新生 胎膜早破 降钙素原 宫内窘迫 败血症 高危因素 

分 类 号：R722.1[医药卫生—儿科]