联合检测血常规、D-二聚体及降钙素原与新生儿败血症继发坏死性小肠结肠炎的关系  

Relationship between combined detection of blood routine,D⁃dimer and procalcitonin and necrotizing enterocolitis secondary to neonatal sepsis

作　　者：王娟 马进[1] 田庆[1] WANG Juan;MA Jin;TIAN Qing(Department of Pediatrics,Wanbei Coal Power Group General Hospital,Suzhou,Anhui,China,234000)

机构地区：[1]安徽省宿州市皖北煤电集团总医院儿科,安徽宿州234000

出　　处：《分子诊断与治疗杂志》2023年第6期1021-1024,1029,共5页Journal of Molecular Diagnostics and Therapy

基　　金：蚌埠医学院自然科学重点科研项目(BYKY2019247ZD)。

摘　　要：目的探讨血常规、D-二聚体(D-D)及降钙素原(PCT)与新生儿败血症继发坏死性小肠结肠炎(NEC)的关系。方法选择2019年8月至2022年9月皖北煤电集团总医院收治的100例新生儿败血症患儿,根据是否继发NEC分为NEC组(n=12)和非NEC组(n=88)。收集两组患儿及孕母围生期的临床资料及检测血常规[白细胞计数(WBC)、平均血小板体积(MPV)、红细胞分布宽度(RDW)、血小板计数(PLT)、中性粒细胞计数(NEUT)]、D-D及PCT水平,多因素Logistic回归分析新生儿败血症继发NEC的独立危险因素,ROC曲线分析血常规、D-D及PCT对新生儿败血症继发NEC的预测价值。结果NEC组和非NEC组患儿的胎龄、喂养方式、脐静脉置管、WBC、MPV、D-D及PCT等比较,差异有统计学意义(t=7.979、5.114、5.634、5.357、4.951,χ^(2)=7.181、13.145、4.495,P<0.05)。多因素Logistic回归分析显示,胎龄、喂养方式、MPV、WBC、D-D及PCT均是新生儿败血症继发NEC的独立有关(P<0.05)。ROC曲线分析显示,MPV、WBC、D-D、PCT及四者联合检测的曲线下面积(AUC)分别为0.685、0.821、0.784、0.703、0.906,优于单一检测(P<0.05)。结论MPV、WBC、D-D及PCT水平均与新生儿败血症继发NEC有关,联合检测对新生儿败血症继发NEC有良好的预测价值。Objective To investigate the relationship between blood count,D⁃dimer(D⁃D)and ProcaIcitonin(PCT)and neonatal sepsis secondary to necrotizing enterocolitis(NEC).Methods One hundred cases of neonatal sepsis admitted to the General Hospital of Wanbei Coal and Electric Group from August 2019 to September 2022 were retrospectively included and divided into the NEC group(n=12)and the non⁃NEC group(n=88)according to whether they had secondary NEC.Clinical data and blood tests[white blood cell count(WBC),mean platelet volume(MPV),red blood cell distribution width(RDW),platelet count(PLT),neutrophil count(NEUT)],D⁃D and PCT levels were collected during the perinatal period of the chil⁃dren and pregnant mothers in both groups.Multi⁃factor logistic regression analysis of independent risk factors for neonatal sepsis secondary to NEC,and ROC curve analysis of the predictive value of routine blood,D⁃D and PCT for neonatal sepsis secondary to NEC.Results Comparison of gestational age,feeding method,um⁃bilical vein placement,WBC,MPV,D⁃D and PCT between children in the NEC and non⁃NEC groups showed statistically significant differences(t=7.979、5.114、5.634、5.357、4.951,χ^(2)=7.181、13.145、4.495,P<0.05).Multifactorial logistic regression analysis showed that gestational age,feeding pattern,MPV,WBC,D⁃D and PCT were all ndependently associated with neonatal sepsis secondary to NEC(P<0.05).The ROC curve analysis showed that the area under the curve(AUC)of MPV,WBC,D⁃D,PCT and the combined assay of the four was 0.685,0.821,0.784,0.703 and 0.906,respectively,which was better than that of the single assay(P<0.05).Conclusion MPV,WBC,D⁃D and PCT levels were all associated with neonatal sepsis secondary to NEC,and the combined test had better predictive value for neonatal sepsis secondary to NEC.

关 键 词：白细胞计数 平均血小板体积 D-二聚体 降钙素原 坏死性小肠结肠炎 

分 类 号：R722.131[医药卫生—儿科]