胰石蛋白对早发型新生儿败血症的早期诊断价值  

Clinical value of serum pancreatic stone protein in the early diagnosis of early-onset neonatal sepsis

作　　者：查丽[1] 胡金绘[1] 朱红利[1] 刘颖颖[1] 武荣[1] ZHA Li;HU Jinhui;ZHU Hongli;LIU Yingying;WU Rong(Neonatal Medical Center,Huai＇an Maternity and Child Heahhcare Hospital Affiliated to Yangzhou University Medical Academy,Jiangsu Province,Huai＇an 223002,China)

机构地区：[1]扬州大学医学院附属淮安市妇幼保健院新生儿医学中心,江苏淮安223002

出　　处：《中国医药导报》2018年第24期88-91,共4页China Medical Herald

基　　金：江苏省妇幼健康科研项目(F201640);江苏省淮安市重点研发计划(社会发展)(HAS2015004)

摘　　要：目的探讨血清胰石蛋白(PSP)对早发型新生儿败血症(EONS)的早期诊断价值。方法选择2014年1~6月入住淮安市妇幼保健院具有细菌感染危险因素或有疑似细菌感染征象且于出生后24 h内入院的新生儿90例,根据是否符合EONS的诊断标准分为败血症组(33例)和非败血症组(57例)。选择20例同期出生一般情况好,没有感染中毒症状的新生儿作为对照组。分别在两组新生儿生后第1、3和7天留取外周血标本,测定血清中PSP和白细胞介素-6(IL-6)水平,并对资料进行统计分析。结果三组血清PSP水平在生后第1、3和7天比较,差异均有高度统计学意义(均P<0.01)。其中败血症组新生儿PSP水平在生后第1、3和7天均高于非败血症组,差异均有统计学意义(均P<0.05);败血症组新生儿血清PSP水平在生后0~3 d呈上升趋势,生后3~7 d呈下降趋势。生后第1天血清PSP水平诊断EONS的曲线下面积为0.802(95%CI:0.700~0.903,P<0.01)。生后第3天血清PSP水平诊断EONS的曲线下面积为0.836(95%CI:0.743~0.930,P<0.01);联合生后第1天血清PSP水平与生后第1天血清IL-6水平诊断EONS的ROC曲线下面积为0.879(95%CI:0.804~0.953,P<0.01)。结论新生儿血清PSP水平对早期诊断EONS具有一定的临床价值。联合检测出生后1 d血清PSP和IL-6水平能提高EONS的诊断敏感性并降低漏诊率。Objective To evaluate the value of serum pancreatic stone protein（PSP） for the early diagnosis of earlyonset neonatal sepsis（EONS）. Methods Ninety neonatal with infectious risk factors or infectious symptoms admitted to the Huai＇an Maternity and Child Healthcare Hospital Affiliated to Yangzhou University Medical Academy within 24 h after birth from January to June 2014 were enrolled. They were divided into sepsis group（ 33 cases） and non-sepsis group（57 cases） depending on whether the diagnostic standard of early-onset neonatal sepsis was met. Twenty neonatal with good general situations admited at the same time without infection poisoning manifestation were treated as the control group. The blood samples were obtained from children on 1, 3 and 7 d after birth. The levels of serum PSP and IL-6 were measured, and the data was statistical analyzed. Results There were statistically significant among three groups at all time points（all P〈0.01）, and the levels of serum PSP on 1, 3 and 7 d after birth in sepsis group were all higher than those of the non-sepsis group, the differences were statistically significant（all P〈0.05）.Levels of serum PSP showed upward trend during d1-d3 after birth, and downward trend during d3-d7. Area under the curve（AUC） of ROC of PSP at 1 d after birth in the diagnosis of sepsis was 0.802 [95%CI： 0.70-0.90, P〈0.01], 3 d after birth was 0.836（95%CI 0.74-0.93, P〈0.01）, the AUC of the combination of PSP and IL-6 in the diagnosis of sepsis at 1 d after birth was 0.879（95%CI： 0.80-0.95, P〈0.01）. Conclusion The level of serum PSP of neonatal has certain clinical value in early diagnosis of EONS. Combination detection of serum PSP and IL-6 in the diagnosis of sepsis at 1 d after birth can improve the sensibility to diagnose early-onset neonatal sepsis and reduce the rate of missed diagnosis.

关 键 词：新生儿 早发型败血症 胰石蛋白 白介素-6 

分 类 号：R722.131[医药卫生—儿科]