新生儿败血症早期诊断指标的价值评价  

Evaluation on Significance of Different Parameters in Early Diagnosis of Neonatal Septicemia

作　　者：冯斯斯[1] 钟白云[1] 邓辉[1] 张秋焕[1] 谢婷彦[1] 

机构地区：[1]中南大学湘雅医院检验科,湖南长沙410008

出　　处：《实用预防医学》2013年第6期743-745,共3页Practical Preventive Medicine

摘　　要：目的探讨C反应蛋白(CRP)、降钙素原(PCT)及白细胞、血小板计数在新生儿败血症早期诊断中的应用价值。方法采用免疫比浊法测定CRP、酶联荧光分析技术测定PCT、5 differ血细胞分析仪计数白细胞与血小板,观察各项指标诊断新生儿败血症灵敏度、特异度,分析ROC曲线。采用Binary Logistic回归建立预测概率模型,获得新的统计量,计算各曲线下面积(AUC),获得最佳诊断点。结果新生儿败血症组CRP和PCT的阳性率较非感染组显著升高(P<0.05),AUC分别为0.676、0.690。CRP、PCT联合WBC检测的AUC为0.856。结论 CRP和PCT对新生儿败血症的早期诊断有重要意义,CRP、PCT联合WBC可提高诊断的灵敏性和特异性。Objective To study the application value of serum C-reactive protein（CRP）,procalcitonin（PCT）,white blood cell（WBC） and blood plate（PLT） counts in the early diagnosis of neonatal septicemia（NS）.Methods The levels of serum CRP and PCT were detected by immune turbidimetry and ELFA,respectively.5-Differential Automatic Hematology Analyzer was used to measure WBC and PLT.The sensitivities and specificities of the above-mentioned parameters in the early diagnosis of NS were calculated.Receiver-operating characteristic curves（ROC） were analyzed.Based on the Binary Logistic regression model,the predictors or probabilities were obtained and applied to establish the empirical and binormal model of the ROC curves and to compare the area under the curve（AUC）.Results A highly significant difference in the positive rates of CRP and PCT were noted between NS group and non-NS group（P0.05）.The AUCs of CRP and PCT were 0.676 and 0.690,respectively.The combined predicted ROC AUC was 0.856.Conclusions The levels of CRP and PCT are valuable predictors for early diagnosis of NS.Using the combined predictors of CRP,PCT and WBC can elevate the sensitivity and specificity of NS diagnosis.

关 键 词：新生儿败血症 C反应蛋白 降钙素原 白细胞 血小板 早期诊断 

分 类 号：R515.3[医药卫生—内科学]