新生儿医院感染危险因素及血清PCT与CRP和25(OH)D3检测价值  

Risk factors for hospital-acquired infection in neonates and value of detection of serum PCT,CRP and 25(OH)D3

作　　者：李淑妮[1] 卢维城[1] 蔡容燕 伍芳芳 许晨耘[1] LI Shu-ni;LU Wei-cheng;CAI Rong-yan;WU Fang-fang;XU Chen-yun(Hainan General Hospital(Affiliated Hospitalof Hainan Medical University),Haikou,Hainan 570311,China)

机构地区：[1]海南省人民医院(海南医学院附属海南医院)新生儿科,海南海口570311

出　　处：《中华医院感染学杂志》2020年第18期2830-2834,共5页Chinese Journal of Nosocomiology

基　　金：海南省医药卫生科研基金资助项目(15A200100)。

摘　　要：目的研究新生儿医院感染(HAI)危险因素及血清降钙素原(PCT)、C-反应蛋白(CRP)和25羟维生素D3[25(OH)D3]检测价值。方法选取2017年1月-2018年12月海南省人民医院(海南医学院附属海南医院)发生HAI的新生儿120例,并依据病情严重程度将HAI患儿分为轻症组和重症组,同时选取240名健康新生儿作为对照组,分析新生儿HAI危险因素,观察PCT、CRP和25(OH)D3对HAI病情严重程度评估价值以及指标之间的相关性。结果HAI组胎龄<37周、出生体质量<2500 g及住院时间≥7 d比例高于对照组,母乳喂养比例低于对照组(P<0.05);Logistic回归分析结果显示胎龄<37周、住院时间≥7 d和非母乳喂养为新生儿发生HAI的独立危险因素(P<0.05);HAI组治疗前和治疗3 d血清PCT和CRP水平均高于对照组,血清25(OH)D3水平低于对照组(P<0.05);重症组血清PCT和CRP高于轻症组,25(OH)D3水平低于轻症组(P<0.05);HAI患儿治疗前血清PCT、CRP和25(OH)D3鉴别病情严重程度的AUC分别为0.786、0.796和0.787;Pearson积差分析显示,HAI患儿治疗前血清PCT和CRP水平均与25(OH)D3呈负相关性(P<0.05)。结论胎龄<37周、住院时间≥7 d和非母乳喂养为新生儿HAI危险因素,检测血清PCT、CRP和25(OH)D3有利于检测患儿病情变化,为临床治疗提供指导依据。OBJECTIVE To explore the risk factors for hospital-acquired infection(HAI)in neonates and analyze the value of detection of serum procalcitonin(PCT),C-reactive protein(CRP)and 25-hydroxyvitamin D3[25(OH)D3].METHODS A total of 120 neonates with HAI who were treated in Hainan General Hospital from Jan 2017 to Dec 2018 were enrolled in the study and divided into the mild group and the severe group according to the severity of disease,meanwhile,240 healthy neonates were set as the control group.The risk factors for HAI were analyzed,the value of the PCT,CRP and 25(OH)D3 in assessment of illness condition was analyzed,and the correlation among the indexes was observed.RESULTS The proportions of the neonates with gestational age less than 37 weeks,birth weight less than 2500 g and length of hospital stay no less than 7 days were significantly higher in the HAI group than in the control group,and the proportion of the neonates with breast feeding of the HAI group was significantly lower than that of the control group(P<0.05).The result of logistic regression analysis showed that the gestational age less than 37 weeks,length of hospital stay no less than 7 days and non-breast feeding were the independent risk factors for HAI in the neonates(P<0.05).The levels of serum PCT and CRP of the HAI group were significantly higher than those of the control group before the treatment and after the treatment for 3 days,and the serum 25(OH)D3 level of the HAI group was significantly lower than that of the control group(P<0.05).The levels of serum PCT and CRP of the severe group were significantly higher than those of the mild group,and the 25(OH)D3 level of the severe group was significantly lower than that of the mild group(P<0.05).The AUCs of the serum PCT,CRP and 25(OH)D3 were respectively 0.786,0.796 and 0.787 in identification of illness condition of the neonates with HAI before the treatment.Pearson product-moment analysis indicated that the levels of serum PCT and CRP were negatively correlated with the 25(OH)D3 before the tr

关 键 词：新生儿 医院感染 危险因素 降钙素原 C-反应蛋白 25羟维生素D 

分 类 号：R197.323[医药卫生—卫生事业管理]