新生儿败血症173例早期实验检查分析  

Analysis for Early Experimental Examination on Neonatal Septicemia in 173 Cases

作　　者：花少栋[1] 安胜利[2] 黄婕婷[1] 吴志新[1] 刘秀香[3] 封志纯[1] 

机构地区：[1]北京军区总医院八一儿童医院新生儿重症监护中心,北京100700 [2]南方医科大学生物统计学系 [3]山东省滨州医学院附属医院新生儿科

出　　处：《中华妇幼临床医学杂志（电子版）》2012年第6期579-582,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家卫生部科研基金资助项目(WKJ2007-3-001)

摘　　要：目的探讨新生儿败血症早期实验检查特点。方法选择2009年1月至2010年12月于北京军区总医院八一儿童医院新生儿重症监护中心(NICU)接受治疗的3111例新生儿的病历资料为研究对象。对其采用回顾性分析法进行相关研究,将本组3111例新生儿中,确诊为新生儿败血症的患儿纳入败血症组(n=173),其余新生儿纳入对照组(n=2938)(本研究遵循的程序符合北京军区总医院八一儿童医院人体试验委员会所制定的伦理学标准,得到该委员会批准)。两组患儿性别、出生体重、分娩方式、胎龄等比较,差异无统计学意义(P>0.05)。结果败血症组与对照组组新生儿的血常规及血生化检测结果中,血红蛋白(Hb)、血小板(PLT)计数、红细胞平均容积(MCV)及血糖(Glu)水平在败血症组较对照组显著降低,而C-反应蛋白(CRP),总胆红素(TBIL),直接胆红素(DBIL),血乳酸(LAC),血尿素氮(BUN)在败血症组较对照组显著增高,且两组比较,差异均有统计学意义(P<0.05)。以上述初筛有意义的9项指标中,PLT,MCV,CRP,TBIL,BUN,Glu,LAC7项指标为是否发生新生儿败血症的因变量,进一步进行多因素非条件logistic回归分析的结果显示,均为导致新生儿败血症的较敏感指标(OR=0.744～1.512,95%CI:0.631～1.772;P<0.05)。结论若新生儿CRP,TBIL,LAC,BUN值越高,而PLT,MCV,Glu值越低,则发生败血症的风险越大,临床上应尽早采取有力的治疗措施。Objective To study the characteristics of early laboratory tests on neonatal septicemia. Methods This was a prospective observational study with institutional ethics approval and written maternal consent. There were 3111 cases of clinical medical records of neonatal were selected from neonatal intensive care unit （NICU）of BaYi Children′s Hospital in the General Military Hospital of Beijing from January 2009 to December 2010. a total of 173 neonates with neonatal septicemia were included in neonatal septicemia group （n=173）and the others included in control group（n=2938）.The blood samples were collected from neonates for blood routine test and routine biochemical analysis,There had no significance difference between two groups among gender,birth weight, mode of delivery, gestational age at delivery,etc.（P0.05）. The relationship between neonatal septicemia related risk factors and results of blood routine test and routine biochemical analysis were analyzed by multivariate non-conditional logistic regression. Results Compared with the control group, hemoglobin （Hb）, platelet （PLT）, mean corpuscular volume （MCV）, blood glucose （Glu）in neonatal septicemia group were significantly lower than those in control group （P0.05）, but C-reacting protein （CRP）, total bilirubin （TBIL）, direct bilirubin （DBIL）, lactate （LAC）, blood urea nitrogen （BUN） in neonatal septicemia group were significantly higher than those in control group （P0.05）. Multivariate non-conditional logistic regression analysis on risk factors of neonatal septicemia was used further, dependent variable, covariates were PLT, Hb, MCV, CRP, TBIL, DBIL,BUN,Glu,LAC, the results showed those close correlation risk factors of neonatal septicemia including： PLT,MCV,CRP,TBIL,BUN,Glu and LAC （OR=0.744-1.512, 95%CI：0.631-1.772; P0.05）. Conclusions The higher of CRP,TBIL,LAC,BUN values and the lower of PLT,MCV,Glu vales, the greater of the risk of neonatal septicemia. It is necessary to take effective

关 键 词：新生儿 败血症 C反应蛋白 血小板 乳酸 

分 类 号：R722.1[医药卫生—儿科]