超敏C-反应蛋白与降钙素原和血清淀粉酶样蛋白A检测对新生儿早期感染的诊断价值  

Diagnostic value of high sensitivity C-reactive protein,procalcitonin and serum amylase-like protein A detection in neonatal early infection

作　　者：石祖亮[1] 胡洪波[1] 杨林[1] 熊潜涛 王珍慧[1] 韩代成[2] 田婷 SHI Zu-liang;HU Hong-bo;YANG Lin;XIONG Qian-tao;WANG Zhen-hui;HAN Dai-cheng;TIAN Ting(Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei 430070, Chin)

机构地区：[1]湖北省妇幼保健院检验科,湖北武汉430070 [2]湖北省妇幼保健院新生儿科,湖北武汉430070

出　　处：《中华医院感染学杂志》2018年第12期1896-1899,1903,共5页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金资助项目(2009CDZ021)

摘　　要：目的探讨超敏C-反应蛋白(High-sensitivity C-reactive protein,hs-CRP)、降钙素原(Procalcitonin,PCT)和血清淀粉酶样蛋白A(Serum amyloid-like proteinA,SAA)检测对新生儿早期感染的诊断价值。方法选取2015年1月-2016年12月医院收治的新生儿90例,按临床表现及实验室检测分为:细菌感染组54例和病毒感染组36例。选取同期医院收治的健康新生儿50例为对照组。患儿接受治疗前和恢复期(入院第7天)分别采取静脉血,对照组在入院时抽静脉血一次,观察三组患儿血清PCT,hs-CRP与SAA的含量。并分析PCT、hs-CRP和SAA单独检测和联合检测对诊断新生儿早期感染的灵敏度、特异性和准确率。结果治疗前,细菌感染组患儿血清中hs-CRP、PCT、SAA及白细胞计数(WBC)高于其他两组(P<0.001);病毒感染组患儿血清中PCT、SAA及WBC高于对照组(P<0.001);治疗后,细菌感染组患儿血清中hs-CRP、PCT、SAA及WBC分别为(2.08±0.18)mg/L、(0.20±0.06)ng/ml、(0.96±0.13)ng/L及(10.59±2.47)×109/L较治疗前均下降(P<0.001);病毒感染组患儿血清中PCT、SAA及WBC分别为(0.15±0.28)ng/ml、(0.91±0.13)ng/L及(9.78±3.25)×109/L较治疗前均下降(P<0.001);细菌感染组患儿血清中hs-CRP高于病毒感染组(P<0.001);细菌感染组与病毒感染组患儿治疗后血清中PCT、SAA及WBC差异无统计学意义。血清hs-CRP、PCT、SAA联合检测对新生儿感染诊断的灵敏度高达95.00%,特异性高达97.50%,准确度达到100.00%优于单独使用。结论血清hs-CRP、PCT和血清SAA联合检测提高了新生儿感染早期诊断的灵敏度、特异性和准确度,具有一定的临床意义。OBJECTIVE To investigate the diagnostic value of high sensitivity C-reactive protein（hs-CRP）,procalcitonin（PCT）and serum amylase-like protein A（SAA）detection in neonatal early infection.METHODS A total of90 cases of neonates admitted in our hospital from Jan.2015 to Dec.2016 were selected,and divided into two groups according to clinical manifestations and laboratory tests：bacterial infection group（54 cases）and virus infection group（36 cases）.Fifty healthy neonates admitted to our hospital were selected as control group.Before treatment and during recovery（the 7 th day after admission）,bacterial infection group were taken venous blood,the control group were taken blood once at the time of admission to hospital.The levels of serum PCT,hs-CRP and SAA in the three groups were measured.And the sensitivity,specificity and accuracy of PCT,hs-CRP and SAA detection alone and together of early neonatal infection were analyzed.RESULTS The levels of hs-CRP,PCT,SAA and WBC were significantly increased in children with bacterial infection before treatment than those in other two groups（P〈0.001）,while the levels of PCT,SAA and WBC in children with viral infection were significantly higher than those in control group（P〈0.001）.After treatment,the levels of serum hs-CRP,PCT,SAA and WBC in bacterial infection group were（2.08±0.18）mg/L,（0.20±0.06）ng/ml,（0.96±0.13）ng/L and（10.59±2.47）×109/L,which were significantly decreased（P〈0.001）.The levels of serum PCT,SAA and WBC in viral infection group after treatment were（0.15±0.28）ng/ml,（0.91±0.13）ng/L and（9.78±3.25）×109/L,which were significantly decreased（P〈0.05）.The hs-CRP level in children with viral infection was significantly lower than that in children with bacterial infection（P〈0.05）.The serum levels of PCT,SAA and WBC in children with bacterial infection and viral infection after treatment showed no significant difference.The sensitivity,specificity and accuracy of combined detection of se

关 键 词：新生儿感染 超敏C-反应蛋白 降钙素原 联合检测 

分 类 号：R446.62[医药卫生—诊断学]