PCT、CRP、CD64在细菌性新生儿败血症中的应用  

Application of PCT,CRP and CD64 in bacterial neonatal sepsis

作　　者：姜燕[1] 任荣 曹博[1] JIANG Yan;REN Rong;CAO Bo(Department of Neonatology,Baoji Maternal and Child Health Hospital,Shaanxi Baoji 721000,China)

机构地区：[1]宝鸡市妇幼保健院新生儿科,陕西宝鸡721000

出　　处：《中国妇幼健康研究》2022年第2期67-71,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的观察血清降钙素原(PCT)、C反应蛋白(CRP)、分化群抗原64(CD64)水平在细菌性新生儿败血症临床诊断与疗效评估中的应用价值。方法选取2017年6月至2020年7月宝鸡市妇幼保健院95例细菌性新生儿败血症患者(观察组)、50例局部感染新生儿(局部感染组)及50例健康新生儿(对照组),检测其血清PCT、CRP及CD64水平,并评估观察组治疗前后全身性感染相关性功能衰竭(SOFA)评分与小儿危重评分(PCIS),利用受试者工作特征(ROC)曲线分析PCT、CRP、CD64对细菌性新生儿败血症诊断效能,并分析其与SOFA评分、PCIS评分的相关性。结果三组PCT、CRP、CD64水平比较差异有统计学意义(F值分别为1499.688、935.497、617.575,P<0.05),且观察组PCT、CRP、CD64水平高于其余两组,局部感染组PCT、CRP水平高于对照组;治疗后PCT、CRP、CD64及SOFA评分较治疗前均降低,PCIS评分较治疗前升高,差异有统计学意义(t值分别为89.124、61.643、26.828、54.887、-17.742,P<0.05);PCT、CRP、CD64与SOFA评分呈正相关(r值分别为0.884、0.836、0.795,P<0.05),与PCIS评分呈负相关(r值分别为-0.892、-0.917、-0.863,P<0.05);PCT、CRP、CD64及三者联合诊断细菌性新生儿败血症敏感度分别为75.6%、60.53%、81.3%、89.8%,特异度分别为82.4%、85.7%、87.9%、90.2%。结论血清PCT、CRP联合CD64对细菌性新生儿败血症具有较高诊断效能,动态监测其水平变化可用于临床疗效评估。Objective To observe the application values of serum procalcitonin(PCT),C-reactive protein(CRP)and cluster of differentiation antigen 64(CD64)levels in clinical diagnosis and efficacy assessment of bacterial neonatal sepsis.Methods Totally 95 patients with bacterial neonatal sepsis(the observation group),50 neonates with local infection(the local infection group)and 50 healthy neonates(the control group)were selected from Baoji Maternal and Child Health Hospital between June 2017 and July 2020.The serum PCT,CRP and CD64 levels in all groups were detected.The systemic sepsis-related organ failure assessment(SOFA)score and pediatric critical illness score(PCIS)of the observation group before and after treatment were evaluated.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic performance of PCT,CRP and CD64 for bacterial neonatal sepsis.Meanwhile,the correlations of the above indexes with SOFA score and PCIS score were analyzed.Results There were statistically significant differences in PCT,CRP and CD64 levels among the three groups(F=1499.688,935.497 and 617.575,respectively,P<0.05).The PCT,CRP and CD64 levels in the observation group were significantly higher than those in the other two groups.The PCT and CRP levels in the local infection group were significantly higher than those in the control group.Compared with before treatment,the levels of PCT,CRP and CD64 and SOFA scores were reduced after treatment,while PCIS scores were increased,and the differences were statistically significant(t=89.124,61.643,26.828,54.887 and-17.742,respectively,P<0.05).PCT,CRP and CD64 levels were positively correlated with SOFA score(r=0.884,0.836 and 0.795,respectively,P<0.05),but negatively correlated with PCIS score(r=-0.892,-0.917 and-0.863,respectively,P<0.05).The sensitivities of PCT,CRP,CD64 alone and in combination to diagnose bacterial neonatal sepsis were 75.6%,60.53%,81.3%,and 89.8%,respectively and the specificities were 82.4%,85.7%,87.9%,and 90.2%,respectively.Conclusion Serum PCT and CR

关 键 词：细菌 新生儿 败血症 降钙素原 C反应蛋白 分化群抗原64 

分 类 号：R722.1[医药卫生—儿科]