新生儿败血症降钙素原的监测对疾病诊断及疗效评估的意义  

Procalcitonin can be used as laboratory indexes of neonatal sepsis

作　　者：肖婷[1] 罗燕[1] 陈丽萍[1] 邱群凤 阙荣良 吴定昌[1] 

机构地区：[1]福建省龙岩市第一医院福建医科大学附属龙岩第一医院检验科,364000

出　　处：《齐齐哈尔医学院学报》2016年第11期1392-1394,共3页Journal of Qiqihar Medical University

基　　金：福建省卫生厅青年科研资助课题(项目编号:2013-2-149)

摘　　要：目的探讨新生儿败血症降钙素原PCT的动态变化,并与其他炎性指标的曲线下面积比较,结合APACHE-Ⅱ评分共同评估其对新生儿败血症早期诊断、疗效评估的临床意义。方法选取2014年7月至2015年7月福建医科大学附属龙岩第一医院新生儿重症监护室61例败血症新生儿进行研究,健康新生儿对照组35例。在治疗前、治疗第1天、第3天分别进行PCT、CRP、WBC等指标检测及APACHE-Ⅱ评分。建立ROC曲线,比较PCT在新生儿脓毒症诊断中的临床应用价值。实验数据采用SPSS 19.0统计软件进行t检验、ROC曲线分析、Pearson相关分析。结果败血症组与健康对照组比较PCT水平存在显著性差异(t=11.043,P<0.01);败血症患儿PCT、WBC、CRP等指标在治疗前、后均有明显降低(P<0.01),败血症患儿PCT的ROC曲线下面积为0.859,与WBC、CRP曲线下面积比较差异有统计学意义(P均<0.01),PCT的敏感度、特异度分别为85.2%、85.7%,治疗前PCT水平与APACHE-Ⅱ评分呈显著正相关(R=0.261,P=0.042),治疗第1天、治疗第3天PCT水平与APACHE-Ⅱ评分不相关(R=-0.180,R=-0.052,P值均>0.05)。结论 PCT是新生儿败血症早期诊断和病情评估的实验室指标之一。Objective To study the dynamic change of procalcitonin in patients with neonatal sepsis,and compared the area under the curve with other inflammatory indexes,and evaluated the clinical significance on early diagnosis and curative effect evaluation combined with APACHE- Ⅱ score. Methods 61 cases with neonatal sepsis admitted in neonatal intensive care unit in Longyan first hospital affiliated to Fujian medical university during July 2014 to July 2014 and 35 cases of healthy newborn were selected. The concentration of PCT,CRP and WBC and APACHE- Ⅱ score were measured at the time point before treatment,1 day after treatment,3 days after treatment. The ROC curve was established,explored the clinical application value of PCT in the diagnosis of neonatal sepsis. The experimental data was analyzed by using SPSS19. 0 statistical software.Results Among the 61 cases of newborns,average age was 14. 45 ＋ /- 10. 36,38 patients（ 62. 29%） were male,23 patients（ 37. 71%） were female,the PCT level of sepsis group compared to healthy control group existed significant difference（ t = 11. 043,P〈0.01）. The concentration of PCT,WBC and CRP index in sepsis group were significantly decreased compared with control group at the time point before and after the treatment（ P〈0.01）,the area under the ROC curve of PCT in sepsis patients was 0. 859,which was statistically different from the WBC,CRP area under the curve（ P〈0.01）,the sensitivity and specific degree of the PCT was 85%and 90% respectively,the PCT level was significantly positively related to APACHE- Ⅱ score before treatment（ R = 0. 261,P = 0. 261）. However,1 day and 3 days after treatment PCT level was not associated with APACHE- Ⅱ score（ R = 0. 180,R = 0. 180,P〉0. 05）. Conclusions This study suggests that PCT is one of the laboratory indexes in early diagnosis of neonatal sepsis and condition assessment.

关 键 词：败血症 PCT 新生儿 

分 类 号：R722.131[医药卫生—儿科]