外周血PCT、SAA及CD64检测诊断新生儿败血症的价值  

Value of peripheral blood PCT,SAA and CD64 detection in the diagnosis of neonatal sepsis

作　　者：许哲 陈静[2] 孙红启 杨建伟[1] 李铁威 Xu Zhe;Chen Jing;Sun Hongqi;Yang Jianwei;Li Tiewei(Department of Laboratory,Children’s Hospital Affiliated to Zhengzhou University,Zhengzhou Key Laboratory of Children’s Infection and Immunity,Zhengzhou 450018,China;Department of Hematology Oncology,Children’s Hospital Affiliated to Zhengzhou University,Henan Key Laboratory of Pediatric Hematology,Zhengzhou 450018,China)

机构地区：[1]郑州大学附属儿童医院检验科,郑州市儿童感染与免疫重点实验室,郑州450018 [2]郑州大学附属儿童医院血液肿瘤科,河南省小儿血液医学重点实验室,郑州450018

出　　处：《中国实用医刊》2022年第16期78-81,共4页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20210672)。

摘　　要：目的探讨外周血降钙素原(PCT)、淀粉样蛋白A(SAA)及中性粒细胞表面分子CD64(以下简称CD64)检测诊断新生儿败血症的价值。方法抽取郑州大学附属儿童医院2020年12月至2021年12月收治的新生儿败血症患儿120例作为观察组,另抽取同期收治的非感染新生儿120例作为对照1组及同期接待的健康新生儿120例作为对照2组。三组新生儿均采集外周血检测PCT、SAA、CD64水平,同时对观察组患儿实施血培养,总结细菌感染类型。对比三组检测结果,分析单独检测、联合检测诊断新生儿败血症的价值,比较不同细菌感染的检测结果。结果观察组PCT、SAA、CD64水平高于对照1组与对照2组,差异有统计学意义(P<0.05),对照1组PCT、SAA、CD64水平高于对照2组(P<0.05)。联合检测诊断灵敏度、特异度、准确度均高于PCT、SAA、CD64单一检测(P均<0.05);革兰阴性菌感染与革兰阳性菌感染在PCT与CD64上比较差异有统计学意义,前者更高(P<0.05),但二者在SAA上比较差异未见统计学意义(P>0.05)。结论相比非感染新生儿与健康新生儿,败血症新生儿有明显的外周血PCT、SAA、CD64水平升高现象,三者联合检测可提高诊断价值,还可鉴别病原菌类型,从而为临床诊治新生儿败血症提供可靠依据。Objective To investigate the value of peripheral blood procalcitonin(PCT),serum amyloid A(SAA)and neutrophil surface molecule CD64(CD64)in the diagnosis of neonatal sepsis.Methods One hundred and twenty neonatal sepsis cases admitted to Children’s Hospital Affiliated to Zhengzhou University from December 2020 to December 2021 were selected as the observation group,120 non-infected neonates admitted during the same period were selected as the control group 1,and 120 healthy neonates received during the same period were selected as the control group 2.The levels of PCT,SAA,and CD64 in the peripheral blood of the newborns in the three groups were detected,while the observation group underwent blood culture,and the types of bacterial infection were summarized.The test results of the three groups were compared,the value of the three single diagnoses and combination of them were compared,and the test results of patients with different bacterial infections were compared.Results The levels of PCT,SAA and CD64 in the observation group were significantly higher than those in the control group 1 and the control group 2,and the differences were significant(P<0.05);and the levels of PCT,SAA and CD64 in the control group 1 were higher than those in the control group 2(P<0.05).The sensitivity,specificity and accuracy of combined detection were higher than those of PCT,SAA,and CD64 single diagnosis,and the differences were all statistically significant(all P<0.05).There was a significant difference in PCT and CD64 level between patients with gram-negative bacterial infection and with gram-positive bacterial infection,and the former was higher(P<0.05),but there was no significant difference in SAA level between patients with gram-negative bacterial infection and with gram-positive bacterial infection(P>0.05).Conclusions Compared with non-infected neonates and healthy neonates,septic neonates have significantly increased levels of PCT,SAA,and CD64 in peripheral blood.The combined diagnosis of PCT,SAA,and CD64 can improve the dia

关 键 词：新生儿败血症 降钙素原 淀粉样蛋白A 中性粒细胞表面分子CD64 联合诊断 细菌感染 

分 类 号：R722.131[医药卫生—儿科]