降钙素原C反应蛋白 心肌酶联合检测在新生儿高胆红素血症诊断中的价值  

Clinical significance of procalcitonin,C-reactive protein and myocardial enzymes determination in patients with neonatal hyperbilirubinemia

作　　者：耿波 梁锋 夏国新 管学平[4] 

机构地区：[1]郧县妇幼保健院检验科,湖北十堰442500 [2]武汉第二中西医结合医院检验科,湖北武汉430071 [3]湖北省荣军医院检验科,湖北武汉430071 [4]湖北医药学院附属人民医院检验部,湖北十堰442000

出　　处：《国际检验医学杂志》2014年第18期2441-2443,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨降钙素原(PCT)、C反应蛋白(CRP)、心肌酶联合检测在新生儿高胆红素血症诊断中的价值。方法收集该院确诊的由败血症、肺炎、ABO溶血、母乳性黄疸导致的新生儿高胆红素血症患者各30例,新生儿肝炎和低体质量早产儿引发的新生儿高胆红素血症患者各20例。选取同期本院产科足月健康新生儿30例作为对照组。对上述纳入对象进行PCT、CRP、心肌酶[包括天门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]水平的检测和分析。结果与对照组比较,新生儿高胆红素血症细菌感染组PCT、CRP水平升高(P<0.05);心肌酶浓度在感染组和非感染组均升高(P<0.05);细菌感染组、早产儿组及溶血症组CK-MB水平显著升高(P<0.01),母乳性黄疸组和肝炎组CK-MB水平也升高(P<0.05);肝炎组AST、LDH活性显著升高(P<0.01)。PCT在细菌性感染组中的诊断特异度明显高于CRP(P<0.05),而在肺炎组中灵敏度显著低于CRP(P<0.01)。结论 PCT、CRP、心肌酶的变化与新生儿高胆红素血症的发生、发展有密切的关系,这几项指标的检测可互为补充。Objective To investigate the clinical value of joint detection of procalcitoninl （PCT ） ,C-reactive protein （CRP） ,and myocardial enzymes in patients with neonatal hyperbilirubinemia .Methods 30 cases of each cause were included in the study ,which were neonatal hyperbilirubinemia caused by sepsis ,pneumonia ,ABO hemolytic and breast milk jaundice .20 cases of each cause were selected including neonatal hyperbilirubinemia caused by neonatal hepatitis and low birth weight infants .All the cases involved in the study were diagnosed .30 healthy full-term newborns in the same period were recruited as control group .PCT ,CRP and myocar-dial enzymes （AST ,CK ,CK-MB ,and LDH） concentration in serum were determined .Results Compared with the control group , CRP and PCT concentration increased significantly in bacterial infected group （P〈 0 .05） .Myocardial enzyme concentration in-creased significantly both in infected group and non-infected group（P〈0 .05） .Among myocardial enzymes ,CK-MB concentration increased significantly in bacterial infected group ,low birth weight infants group and ABO hemolytic group（P〈0 .01） and increased significantly in breast milk jaundice group and hepatitis group （P〈0 .05） .AST and LDH concentration increased very significantly in hepatitis group（P〈0 .01） .The specificity of PCT in bacterial infected group was significantly higher than that of CRP （P〈0 .05） ,while its sensitivity was significantly lower than that of CRP in pneumonia group （P〈0 .01） .Conclusion Changes of PCT , CRP and myocardial enzymes concentration are related to the occurrence and development of neonatal hyperbilirubinemia ,determi-nation of these indicators can be complementary .

关 键 词：新生儿高胆红素血症 降钙素原 C反应蛋白 心肌酶 

分 类 号：R722.1[医药卫生—儿科]