降钙素原在早产低出生体重儿医院感染败血症早期诊断的临床意义  

Clinical Significance of Procalcitonin Test in the Early Diagnosis of Hospital-Acquired Sepsis in Low Birth Weight Infants

作　　者：萧慧敏[1] 吕兴[1] 罗素云[1] 廖艳霞[1] 

机构地区：[1]广东医学院附属厚街医院儿科,广东东莞523945

出　　处：《黑龙江医学》2015年第7期856-858,共3页Heilongjiang Medical Journal

摘　　要：目的探讨降钙素原在早产低出生体重儿医院感染败血症早期诊断的临床意义。方法选择我院分娩的早产低出生体重儿,其中医院感染败血症组30例,无败血症对照组30例,入院后使用抗生素前、抗生素治疗72 h后抽取静脉血检测降钙素原(PCT)与超敏C反应蛋白(hs-CRP),hs-CRP与PCT诊断医院感染败血症进行诊断性试验比较。结果与无败血症对照组相比,医院感染败血症组早产低出生体重儿PCT和hs-CRP的含量均明显升高,以PCT>2 ng/m L诊断败血症的敏感性为90.3%,特异性为86.4%,阳性预测值和阴性预测值分别为88.3%、91.3%,诊断准确性为89.2%均较hs-CRP高。治疗72 h后败血症组PCT显著下降,新生儿危重症评分(NCIS)显著升高,两者呈负相关(P<0.05)。结论 PCT对于早期诊断早产低出生体重儿医院感染败血症具有较高的诊断准确性,能评估病情危重程度,具有一定的临床应用价值。Objective To investigate the clinical significance of procalcitonin test in the early diagnosis of hospital- acquired sepsis in low birth weight infants. Methods 60 low birth weight infants in the neonatology ward were divided into sepsis group（ n = 30） and non-infection control group（ n = 30） according to the diagnostic criteria of hospital- acquired sepsis. Serum Procalcitonin（ PCT） and Creactive were measured after hospital admission and previous use of antibiotics,and 72 h after use of antibiotics of the two groups were compared.The diagnostic test of hs- CRP and PCT for hospital- acquired sepsis was conducted. Results The levels of hs- CRP and PCT of hospital- acquired in pretem infants were higher than those of control group. When the cutoff PCT 〉2 ng / mL,diagnosis of hospital- acquired sepsis in pretem infants with a sensitivity was 90. 3%,specificity was 86. 4%,positive and negative values were 88. 3% and 91. 3%,the diagnostic accuracy of 89. 2% were higher than those in hs- CRP. PCT dropped significantly after 72 h treatment in sepsis group,and NCIS raised significantly. Both showed a negative correlation（ P〈0. 05）. Conclusion For early diagnosis of hospital- acquired in low birth weight infants,procalcitonin has a high diagnostic accuracy evaluation in a critical condition. It has certain value in clinical application.

关 键 词：早产低出生体重儿 降钙素原 医院感染 败血症 早期诊断 

分 类 号：R722.6[医药卫生—儿科]