新生儿肠道感染并发NEC病原学及血清PCT、hs-CRP、ENA-78早期诊断价值  

Etiological characteristics of NEC in neonates with intestinal infection and early diagnostic values of serum PCT,hs-CRP and ENA-78

作　　者：袁城城 张凡[1] 李玉峰 李红新[2] YUAN Cheng-cheng;ZHANG Fan;LI Yu-feng;LI Hong-xin(Affiliated Maternity and Child Health Care Hospital of Nantong University,Nantong,Jiangsu226000,China;不详)

机构地区：[1]南通大学附属妇幼保健院新生儿科,江苏南通226000 [2]南通大学附属常州市儿童医院新生儿科,江苏常州213100

出　　处：《中华医院感染学杂志》2024年第1期116-119,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金(81800689)。

摘　　要：目的分析新生儿肠道感染并发坏死性小肠结肠炎(NEC)病原学特点及血清降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)和中性粒细胞活化肽-78(ENA-78)的早期诊断价值。方法选取2019年2月-2021年2月南通大学附属妇幼保健院新生儿科收治的80例肠道感染患儿为研究对象,根据是否合并NEC分为NEC组24例与非NEC组56例,并选取同期住院的40例无肠道感染的新生儿为对照组,统计NEC组患儿病原学分布特点,检测三组患儿血清PCT、hs-CRP及ENA-78水平,受试者工作特征(ROC)曲线分析三指标诊断NEC早期的临床价值。结果24例NEC组患儿共分离出35株病原菌,其中革兰阴性菌居多占57.14%;三组血清PCT、hsCRP及ENA-78水平比较有统计学差异(P<0.05),且NEC组高于非NEC组及对照组(P<0.05);ROC曲线结果显示,血清PCT、hs-C RP、ENA-78对NEC均具有较高的诊断价值,曲线下面积(AUC)分别为0.835、0.920、0.933,三指标联合诊断价值更高,AUC为0.955。结论肠道感染并发NEC病原菌以革兰阴性菌居多,血清PCT、hs-CRP及ENA-78联合检测在NEC早期诊断中具有较高的应用价值。OBJECTIVE To explore the etiological characteristics of necrotizing enterocolitis(NEC)in the neonates with intestinal infection and observe the early diagnostic values of serum procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP)and neutrophil activating peptide-78(ENA-78).METHODS A total of 80 neonates with intestinal infection who were treated in neonatology department of the Affiliated Maternity and Child Health Care Hospital of Nantong University from Feb 2019 to Feb 2021 were recruited as the research subjects and were divid-ed into the NEC group with 24 cases and the non-NEC group with 56 cases according to the status of complication with NEC.Meanwhile,40 hospitalized neonates who did not have intestinal infection were chosen as the control group.The etiological characteristics of the neonates in the NEC group were statistically analyzed,the levels of se-rum PCT,hs-CRP and ENA-78 were detected for the three groups of neo nates,and the clinical values of the three indexes in early diagnosis of NEC were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Totally 35 strains of pathogens were isolated from the 24 neonates in the NEC group,57.14%of which were gram-negative bacteria.There were significant differences in the levels of serum PCT,hs-CRP and ENA-78 among the three groups(P<0.05),and the levels of the above indexes of the NEC group were higher than those of the non-NEC group and the control group(P<0.05).The result of ROC curve analysis showed that the serum PCT,hs-CRP and ENA-78 had high values in diagnosis of NEC,the areas under curves(AUCs)were 0.835,0.920 and 0.933,respectively;the joint detection of the three indexes had higher diagnostic value,with the AUC 0.955.CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the intestinal infection neonates complicated with NEC.The joint detection of serum PCT,hs-CRP and ENA-78 has high value in early diagnosis of NEC.

关 键 词：新生儿坏死性小肠结肠炎 病原菌 降钙素原 超敏C-反应蛋白 中性粒细胞活化肽-78 

分 类 号：R722.1[医药卫生—儿科]