PCT、hs-CRP及二者联合检测对新生儿败血症的诊断价值  

PCT and hs-CRP determinations and the combined determination for the diagnosis of neonatal septicemia

作　　者：谷磊[1] 杨玉芹[1] 王霞[1] GU Lei;YANG Yuqin;WANG Xia(Department of Clinical Laboratory,the Affiliated Huaian First People's Hospital of Nanjing Medical University,Huaian 223300,Jiangsu,China)

机构地区：[1]南京医科大学附属淮安第一医院检验科,江苏淮安223300

出　　处：《检验医学》2018年第7期597-600,共4页Laboratory Medicine

摘　　要：目的探讨血清降钙素原(PCT)及高敏C反应蛋白(hs-CRP)联合检测在新生儿败血症临床诊断中的应用价值。方法选取新生儿细菌性败血症患儿(病例组)156例(日龄≤3 d者88例、日龄4~28 d者68例)及新生儿呼吸窘迫综合征、新生儿窒息患儿(对照组)245例(日龄≤3 d者162例、日龄4~28 d者83例)。按预设的时间段对研究对象采血,分别进行PCT、hs-CRP、血培养及血常规检测,并对资料进行统计分析。结果以血培养结果为金标准,PCT诊断新生儿败血症的敏感性、特异性、阳性预测值、阴性预测值、约登指数≤3 d组分别为94.3%、39.5%、45.9%、92.7%、0.34,4~28 d组分别为85.3%、86.7%、84.1%、87.8%、0.72。hs-CRP诊断新生儿败血症的敏感性、特异性、阳性预测值、阴性预测值、约登指数≤3 d组分别为85.2%、83.3%、73.5%、91.2%、0.69,4~28 d组分别为83.8%、83.1%、80.3%、86.2%、0.67。PCT与hs-CRP联合诊断新生儿败血症的敏感性、特异性、阳性预测值、阴性预测值、约登指数≤3 d组分别为80.7%、90.1%、81.6%、89.6%、0.71,4~28 d组分别为77.9%、90.4%、86.9%、83.3%、0.72。结论在新生儿败血症诊断中,应优先采用PCT和hs-CRP双指标联合检测。Objective To investigate the role of serum procalcitonin(PCT)and high-sensitivity C-reactive protein(hs-CRP)combined determination in the diagnosis and treatment of neonatal septicemia.Methods A total of 156 patients with neonatal septicemia and 245 control neonates were enrolled.There were 88 cases of≤3 d and 68 cases of 4-28 d in septicemia group.There were 162 cases of≤3 d and 83 cases of 4-28 d in control group,and the cases in control group had respiratory distress syndrome and neonatal asphyxia.According to preset periods,the blood samples were collected for PCT and hs-CRP determinations,blood culturing and blood routine test,and the data were analyzed statistically.Results The results of blood culturing were as gold standard.The sensitivities,specificities,positive predictive values,negative predictive values and Youden indices of PCT determination were 94.3%,39.5%,45.9%,92.7%,0.34 for≤3 d group and 85.3%,86.7%,84.1%,87.8%,0.72 for 4-28 d group,respectively.The sensitivities,specificities,positive predictive values,negative predictive values and Youden indices of hs-CRP determination were 85.2%,83.3%,73.5%,91.2%,0.69 for≤3 d group and 83.8%,83.1%,80.3%,86.2%,0.67 for 4-28 d group,respectively.The sensitivities,specificities,positive predictive values,negative predictive values and Youden indices of PCT and hs-CRP combined determination were 80.7%,90.1%,81.6%,89.6%,0.71 for≤3 d group and 77.9%,90.4%,86.9%,83.3%,0.72 for 4-28 d group,respectively.Conclusions The combined determination of PCT and hs-CRP can improve the diagnosis of neonatal septicemia.

关 键 词：降钙素原 高敏C反应蛋白 新生儿 败血症 

分 类 号：R446.62[医药卫生—诊断学]