血清降钙素原与超敏C反应蛋白对新生儿早发性细菌感染的诊断及疗效评估价值  

The value of serum procalcitonin and high-sensitivity C-reactive protein in the diagnosis and efficacy evaluation of neonatal early-onset bacterial infection

作　　者：王晶 殷剑松 吕君 薛梅 万瑜 WANG Jing;YIN Jian-song;LYU Jun(Department of Neonatology,Changzhou Second People’s Hospital Affiliated to Nanjing Medical University,Changzhou 213000,China)

机构地区：[1]南京医科大学附属常州第二人民医院新生儿科,213000

出　　处：《中国实用医药》2021年第11期97-100,共4页China Practical Medicine

摘　　要：目的探讨血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)在新生儿早发性细菌感染中的诊断及疗效评估价值。方法 210例有早发性细菌感染高危因素而无特异临床表现的新生儿,根据出生后24 h内C反应蛋白(CRP)浓度不同分为感染组(CRP≥5 mg/L, 109例)及亚临床感染组(CRP<5 mg/L,101例);另随机选择同期本院出生的无宫内细菌感染高危因素的109例足月新生儿作为对照组。比较三组新生儿的临床资料及hs-CRP、CRP、PCT水平,分析hs-CRP、PCT与CRP的相关性,并应用受试者工作特征曲线(ROC)评价hs-CRP、PCT对新生儿早发性细菌感染的诊断价值。结果感染组与亚临床感染组的顺产率均高于对照组,差异有统计学意义(P<0.05)。治疗前,感染组PCT、hs-CRP、CRP均高于对照组和亚临床感染组,差异有统计学意义(P<0.05);对照组与亚临床感染组PCT、hs-CRP、CRP比较差异无统计学意义(P>0.05)。治疗后,感染组PCT、hs-CRP、CRP均较治疗前下降,差异有统计学意义(P<0.05);亚临床感染组PCT、hs-CRP较治疗前降低, CRP较治疗前升高,差异有统计学意义(P<0.05)。治疗后,感染组与亚临床感染组的PCT比较差异无统计学意义(P>0.05);但感染组hs-CRP和CRP高于亚临床感染组,差异有统计学意义(P<0.05)。PCT及hs-CRP与CRP水平呈显著正相关(r=0.919、0.602, P<0.05)。ROC曲线显示, hs-CRP的曲线下面积大于PCT,最佳临界值小于PCT。结论在新生儿早发性细菌感染的早期诊断中, hs-CRP和PCT能辅助新生儿早发性细菌感染病情严重程度和疗效的评估,指导临床合理使用抗生素。Objective To discuss the value of serum procalcitonin(PCT)and high-sensitivity C-reactive protein(hs-CRP)in the diagnosis and efficacy evaluation of neonatal early-onset bacterial infection.Methods A total of 210 neonates with high-risk factors for early-onset bacterial infection but without specific clinical manifestations were divided into infection group(CRP≥5 mg/L,109 cases)and sub-clinical infection group(CRP<5 mg/L,101 cases)according to concentration of C-reactive protein(CRP)within 24 h after birth.Another 109 full-term neonates without high factors of intrauterine bacterial infection were randomly selected as the control group.The clinical data,and levels of hs-CRP,CRP,PCT of the three groups were compared.The correlations between hs-CRP,PCT and CRP were analyzed,and The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of hs-CRP and PCT for neonatal early-onset bacterial infection.Results The natural delivery rates of infection group and sub-clinical infection group were higher than those of the control group,and the difference was statistically significant(P<0.05).Before treatment,the PCT,hs-CRP and CRP of infection group were higher than those of control group and sub-clinical infection group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in PCT,hs-CRP and CRP between control group and sub-clinical infection group(P>0.05).After treatment,the PCT,hs-CRP and CRP of infection group were lower than those before treatment,and the difference was statistically significant(P<0.05);the PCT and hs-CRP of sub-clinical infection group were lower than those before treatment,and CRP was higher than that before treatment.All the difference was statistically significant(P<0.05).After treatment,there was no statistically significant difference in PCT between infection group and sub-clinical infection group(P>0.05).But the hs-CRP and CRP of infection group were higher than those of sub-clinical infection group,and the diff

关 键 词：新生儿早发性细菌感染 超敏C反应蛋白 降钙素原 C反应蛋白 

分 类 号：R722.1[医药卫生—儿科]