超敏C-反应蛋白、血清降钙素原及白细胞计数在新生儿感染性疾病中的早期诊断价值  

Early diagnostic value of high sensitivity C-reactive protein,serum procalcitonin and white blood cell count in neonatal infectious diseases

作　　者：王丹丹[1] 王瑞[1] 罗智花[1] 周登余[1] 王琍琍[1] WANG Dandan;WANG Rui;LUO Zhihua;ZHOU Dengyu;WANG Lili(Department of Pediatrics,The First Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院儿科,安徽合肥230022

出　　处：《西部医学》2024年第5期686-690,共5页Medical Journal of West China

基　　金：安徽医科大学基础与临床合作研究提升计划项目(2020xkjT035)。

摘　　要：目的研究超敏C-反应蛋白(hs-CRP)、血清降钙素原(PCT)及白细胞(WBC)计数在新生儿感染性疾病的早期诊断价值,为降低临床抗生素使用率及新生儿病死率等提供科学依据。方法将2021年1月—2021年12月本院收治的62例患有感染性疾病的新生儿为病例组,同期同科室收住的50例患新生儿非感染性疾病的病例为对照组,在入院第1天和第7天分别采静脉血对比两组患儿hs-CRP、PCT和WBC的差异,计算hs-CRP、PCT和WBC灵敏度、特异度并绘制ROC曲线。结果入院时病例组hs-CRP、PCT和WBC计数均高于对照组,差异具有统计学意义(P<0.001);入院7天时,病例组hs-CRP、PCT均明显下降,与对照组差异无统计学意义(P>0.05),WBC计数虽较入院时明显下降,但仍较对照组高,差异具有统计学意义(P<0.05);hs-CRP、PCT、WBC计数和hs-CRP+PCT在诊断新生儿感染性疾病的ROC曲线下面积分别是0.954、0.962、0.732和0.985。Hs-CRP+PCT的约登指数最高,曲线下面积最大,其次是PCT、hs-CRP、WBC,差异均具有统计学意义(P<0.05)。结论hs-CRP、PCT和WBC计数在新生儿患有感染性疾病的早期均具有一定的诊断价值,hs-CRP联合PCT有助于早期判断是否使用抗生素。Objective To study the diagnostic value of high-sensitivity C-reactive protein(hs-CRP),serum procalcitonin(PCT)and white blood cell count(WBC)in newborns with infectious diseases,so as to provide evidence for reducing the antibiotic utilization empirically and neonatal mortality.Methods 62 newborns with infectious diseases admitted to our hospital from January 2021 to December 2021 were the case group,and the 50 newborns with non infectious diseases admitted in the same department in the same period were taken as the control group.Venous blood was collected on the 1st day and the 7th day of admission to observe the difference of hs-CRP,PCT and WBC count in the two groups,calculate the sensitivity and specificity of hs-CRP,PCT and WBC,and draw the ROC curve.Results The hs-CRP,PCT and WBC counts of the case group were higher than those of the control group at admission,and the difference was statistically significant(P<0.001).On the 7th day after admission,hs-CRP and PCT in the case group decreased significantly,which was not statistically significant compared with the control group(P>0.05).Although WBC count decreased significantly,but it was still higher than that in the control group(P<0.05).The area under ROC curve of hs-CRP,PCT,WBC count and hs-CRP+PCT in the diagnosis of neonatal infectious diseases were 0.954,0.962,0.732 and 0.985,respectively.The Yodon index of hs-CRP+PCT was the highest,and the area under the curve was the largest,followed by PCT,hs-CRP,and WBC.The differences were statistically significant(P<0.05).Conclusion Hs-CRP,PCT and WBC counts have certain diagnostic value in the early stage of neonatal infectious diseases.Hs-CRP+PCT is helpful to decide whether to use antibiotics.

关 键 词：新生儿感染性疾病 超敏C-反应蛋白 血清降钙素原 白细胞计数 

分 类 号：R722.13[医药卫生—儿科]